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General NPI Number Information
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NPI Number | 1598828485
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Entity Type | Organization
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Legal Business Name | PRESTIGE HOME ATTENDANT INC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/25/2011
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Provider Practice Location Address
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Address Line | 377 BROADWAY 2ND FLOOR FRONT
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City | NEW YORK
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State | NY
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Zip | 10013
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Country | US
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Telephone | 212-334-5480
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Fax | 212-334-5576
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Provider Business Mailing Address
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Address Line | 377 BROADWAY 2ND FLOOR FRONT
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City | NEW YORK
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State | NY
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Zip | 10013
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Country | US
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Telephone | 212-334-5480
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Fax | 212-334-5576
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ESTRELLA Y CHAN
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Credential | RN
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Telephone | 212-334-5480
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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 | 0834L001
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License Number State | NY
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