=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104902949
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOMINICAN SISTERS FAMILY HEALTH SERVICE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/27/2006
-----------------------------------------------------
Last Update Date | 08/28/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 299 N HIGHLAND AVE
-----------------------------------------------------
City | OSSINING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10562-2327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-941-1710
-----------------------------------------------------
Fax | 914-941-0518
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 299 N HIGHLAND AVE
-----------------------------------------------------
City | OSSINING
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10562-2327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-941-1710
-----------------------------------------------------
Fax | 914-941-0518
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF OPERATING OFFICER
-----------------------------------------------------
Name | MR. LOUIS L. HARRIS
-----------------------------------------------------
Credential | BS, MS, DPT, LNHA, F
-----------------------------------------------------
Telephone | 914-941-1710
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 5905901L
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------