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General NPI Number Information
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NPI Number | 1497967269
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Entity Type | Organization
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Legal Business Name | INNOVATIVE HEALTHCARE SYSTEMS, INC.
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 01/22/2009
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Provider Practice Location Address
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Address Line | 23 NAGLE AVE GROUND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10040-1405
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Country | US
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Telephone | 121-254-4903
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Fax | 212-544-9097
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Provider Business Mailing Address
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Address Line | 23 NAGLE AVE GROUND FLOOR
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City | NEW YORK
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State | NY
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Zip | 10040-1405
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Country | US
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Telephone | 121-254-4903
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Fax | 212-544-9097
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. JOAN Y. SHOCKNESS
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Credential |
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Telephone | 212-544-9033
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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 | 0936L001
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License Number State | NY
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