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General NPI Number Information
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NPI Number | 1114583267
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Entity Type | Organization
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Legal Business Name | 1ST HOME CARE OF NY CORP. (CDPAP)
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Dates
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Enumeration Date | 05/14/2019
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Last Update Date | 03/05/2020
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Provider Practice Location Address
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Address Line | 1601 GRAVESEND NECK RD STE 12A
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City | BROOKLYN
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State | NY
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Zip | 11229-4426
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Country | US
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Telephone | 347-523-4127
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Fax | 347-708-9089
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Provider Business Mailing Address
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Address Line | 320 BERNARD DR
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City | MORGANVILLE
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State | NJ
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Zip | 07751-2220
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Country | US
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Telephone | 347-523-4127
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Fax | 347-708-9089
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Authorized Official
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Title or Position | CEO/ADMINISTRATOR
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Name | MS. DILYA KHALITOVA
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Credential |
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Telephone | 347-523-4127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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