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General NPI Number Information
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NPI Number | 1629390760
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Entity Type | Organization
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Legal Business Name | SWEET P HOME CARE
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Dates
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Enumeration Date | 02/16/2010
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Last Update Date | 02/16/2010
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Provider Practice Location Address
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Address Line | 703 TARGEE ST
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City | STATEN ISLAND
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State | NY
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Zip | 10304-3319
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Country | US
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Telephone | 718-556-0478
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Fax |
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Provider Business Mailing Address
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Address Line | 703 TARGEE ST
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City | STATEN ISLAND
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State | NY
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Zip | 10304-3319
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | RN
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Name | JUDITH OBIDIMALOR
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Credential |
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Telephone | 17185560478
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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 | 455440-1
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License Number State | NY
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