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General NPI Number Information
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NPI Number | 1114967924
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Entity Type | Organization
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Legal Business Name | HOME AIDE SERVICE OF EASTERN NEW YORK, INC.
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 03/26/2009
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Provider Practice Location Address
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Address Line | 433 RIVER ST SUITE 3000
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City | TROY
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State | NY
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Zip | 12180-2238
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Country | US
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Telephone | 518-274-6200
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Fax | 518-274-1829
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Provider Business Mailing Address
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Address Line | 433 RIVER ST SUITE 3000
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City | TROY
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State | NY
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Zip | 12180-2238
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Country | US
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Telephone | 518-274-6200
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Fax | 518-274-1829
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Authorized Official
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Title or Position | VP/DIRECTOR
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Name | MRS. MICHELLE T MAZZACCO
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Credential |
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Telephone | 518-270-1310
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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 | 1921901L
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License Number State | NY
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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 | 1921601
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License Number State | NY
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