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General NPI Number Information
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NPI Number | 1295170983
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Entity Type | Organization
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Legal Business Name | BAYADA HOME HEALTH CARE
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Dates
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Enumeration Date | 05/08/2013
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Last Update Date | 05/08/2013
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Provider Practice Location Address
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Address Line | 31 GAETANO LN
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City | CORAM
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State | NY
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Zip | 11727-2343
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Country | US
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Telephone | 631-624-8348
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Fax | 631-846-1026
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Provider Business Mailing Address
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Address Line | 31 GAETANO LN
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City | CORAM
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State | NY
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Zip | 11727-3364
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Country | US
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Telephone | 631-624-8348
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Fax | 631-846-1026
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. MANDY BLAKE-GERMAN
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Credential |
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Telephone | 631-863-3702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | 292701-1
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License Number State | NY
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