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General NPI Number Information
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NPI Number | 1265582050
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Entity Type | Organization
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Legal Business Name | A&B ENTERPRISE OF LI
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 07/30/2019
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Provider Practice Location Address
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Address Line | 2079 WANTAGH AVE 2
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City | WANTAGH
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State | NY
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Zip | 11793-3924
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Country | US
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Telephone | 516-938-5225
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Fax | 516-938-3202
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Provider Business Mailing Address
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Address Line | 2079 WANTAGH AVE. 2
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City | WANTAGH
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State | NY
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Zip | 11793
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Country | US
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Telephone | 516-938-5225
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Fax | 516-938-3202
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN CAMPBELL
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Credential |
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Telephone | 516-826-6333
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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 | 0022L001
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License Number State | NY
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