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General NPI Number Information
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NPI Number | 1174077416
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Entity Type | Organization
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Legal Business Name | ABR HOMECARE OF NY INC.
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Dates
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Enumeration Date | 08/03/2016
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Last Update Date | 08/03/2016
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Provider Practice Location Address
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Address Line | 74365 MAIN RD
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City | GREENPORT
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State | NY
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Zip | 11944-2622
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Country | US
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Telephone | 631-333-2077
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Fax | 631-333-2078
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Provider Business Mailing Address
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Address Line | PO BOX 1848
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City | SHELTER ISLAND
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State | NY
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Zip | 11964-1848
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Country | US
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Telephone | 631-749-5804
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Fax | 631-749-5803
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. J JENNIE P SMITH
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Credential | MA-HCPM
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Telephone | 631-749-5113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 2260L001
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License Number State | NY
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