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General NPI Number Information
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NPI Number | 1205348828
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Entity Type | Organization
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Legal Business Name | UNIFIED PROFESSIONAL CARE, LLC
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Dates
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Enumeration Date | 11/05/2017
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Last Update Date | 11/05/2017
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Provider Practice Location Address
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Address Line | 10214 ROCKAWAY BEACH BLVD 3C
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2743
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Country | US
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Telephone | 917-400-8884
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Fax |
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Provider Business Mailing Address
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Address Line | 10214 ROCKAWAY BEACH BLVD 3C
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2743
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Country | US
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Telephone | 917-400-8884
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ALINA NOVOSELOVA
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Credential | RN
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Telephone | 917-400-8884
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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 |
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License Number State |
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