=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346408077
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | METROPOLITAN HOMECARE WAY, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/29/2008
-----------------------------------------------------
Last Update Date | 05/29/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 156 NAGLE AVE FL 2
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10040-1436
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-664-1794
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 156 NAGLE AVE FL 2
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10040-1436
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-664-1794
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. ALEXANDER L. FREED
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 718-664-1974
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1382L001
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------