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General NPI Number Information
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NPI Number | 1558503136
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Entity Type | Organization
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Legal Business Name | MARY CARE LLC
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Dates
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Enumeration Date | 03/30/2009
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Last Update Date | 01/28/2010
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Provider Practice Location Address
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Address Line | 1860 LAFAYETTE AVE 1B
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City | BRONX
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State | NY
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Zip | 10473-2843
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Country | US
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Telephone | 646-457-7025
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Fax | 347-590-6598
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Provider Business Mailing Address
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Address Line | 1860 LAFAYETTE AVE 1B
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City | BRONX
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State | NY
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Zip | 10473-2843
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Country | US
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Telephone | 646-457-7025
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Fax | 347-590-6598
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Authorized Official
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Title or Position | CHAIR PERSON
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Name | MARY VERITY ATSISEY
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Credential | R.N., L.P.N.
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Telephone | 347-590-6598
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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 | 5719924
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 6357310
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License Number State | NY
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