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General NPI Number Information
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NPI Number | 1255868915
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Entity Type | Organization
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Legal Business Name | BARI HOME CARE LLC
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Dates
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Enumeration Date | 05/12/2017
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Last Update Date | 05/12/2017
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Provider Practice Location Address
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Address Line | 4417 EXPRESS DRIVE NORTH
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City | RONKONKOMA
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State | NY
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Zip | 11779
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Country | US
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Telephone | 631-428-1901
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Fax | 718-898-7100
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Provider Business Mailing Address
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Address Line | 4417 EXPRESS DR N
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City | RONKONKOMA
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State | NY
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Zip | 11779-5519
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Country | US
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Telephone | 631-428-1901
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Fax | 718-898-7100
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Authorized Official
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Title or Position | MANAGER
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Name | MD ABU AHSAN
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Credential |
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Telephone | 631-428-1901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 170510010159
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License Number State | NY
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