=====================================================
General NPI Number Information
=====================================================
NPI Number | 1033717152
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CELTIC CARE RN PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/12/2020
-----------------------------------------------------
Last Update Date | 10/12/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 347 5TH AVE RM 1402
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-5034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-771-3258
-----------------------------------------------------
Fax | 646-205-8209
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 347 5TH AVE RM 1402
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10016-5034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-771-3258
-----------------------------------------------------
Fax | 646-205-8209
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | MRS. KATHLEEN COFFEY STEIMEL
-----------------------------------------------------
Credential | RN
-----------------------------------------------------
Telephone | 646-771-3258
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------