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General NPI Number Information
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NPI Number | 1073944898
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Entity Type | Organization
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Legal Business Name | AMEDISYS PRIVATE DUTY, LLC
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Dates
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Enumeration Date | 12/04/2013
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Last Update Date | 12/04/2013
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Provider Practice Location Address
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Address Line | 25 E SALEM ST
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City | HACKENSACK
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State | NJ
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Zip | 07601-7427
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Country | US
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Telephone | 201-880-8923
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Fax |
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Provider Business Mailing Address
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Address Line | 445 HAMILTON AVE 10TH FLOOR
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City | WHITE PLAINS
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State | NY
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Zip | 10601-1807
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Country | US
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Telephone | 914-428-7722
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Fax | 914-428-2404
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Authorized Official
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Title or Position | COO
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Name | MR. GREGORY TURCHAN
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Credential | MSW, MPA
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Telephone | 914-428-7722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | HP0182100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HP0182100
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License Number State | NJ
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