=====================================================
General NPI Number Information
=====================================================
NPI Number | 1003941071
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VNA EAST,INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2007
-----------------------------------------------------
Last Update Date | 01/10/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34 LEDGEBROOK DR
-----------------------------------------------------
City | MANSFIELD CENTER
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06250-1664
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-456-7288
-----------------------------------------------------
Fax | 860-423-5702
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 34 LEDGEBROOK DR
-----------------------------------------------------
City | MANSFIELD CENTER
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06250-1664
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-456-7288
-----------------------------------------------------
Fax | 860-423-5702
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. CLAUDIA M MARCINCZYK
-----------------------------------------------------
Credential | RN,MS,MBA
-----------------------------------------------------
Telephone | 860-456-7288
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | C81661
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------