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General NPI Number Information
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NPI Number | 1306229489
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Entity Type | Organization
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Legal Business Name | QUEENS HOMECARE AGENCY
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 2 E BROADWAY STE 802
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City | NEW YORK
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State | NY
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Zip | 10038-1094
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Country | US
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Telephone | 917-324-6973
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Fax | 347-368-0618
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Provider Business Mailing Address
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Address Line | PO BOX 686
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City | NEW YORK
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State | NY
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Zip | 10002-0686
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Country | US
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Telephone | 917-324-6973
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ROBERT LUK
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Credential |
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Telephone | 917-324-6973
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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 | 1937L001
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License Number State | NY
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