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General NPI Number Information
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NPI Number | 1386985893
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Entity Type | Organization
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Legal Business Name | NEW DORP 1 INC
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Dates
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Enumeration Date | 03/07/2013
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Last Update Date | 03/07/2013
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Provider Practice Location Address
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Address Line | 6054 AMBOY RD
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City | STATEN ISLAND
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State | NY
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Zip | 10309-3128
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Country | US
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Telephone | 347-838-6311
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Fax | 347-944-5922
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Provider Business Mailing Address
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Address Line | 6054 AMBOY RD
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City | STATEN ISLAND
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State | NY
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Zip | 10309-3128
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Country | US
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Telephone | 347-838-6311
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Fax | 347-944-5922
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Authorized Official
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Title or Position | OWNER
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Name | MS. KHADDOUJ ELHATTAB
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Credential | HHA
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Telephone | 347-698-8538
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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 |
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License Number State | NY
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