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General NPI Number Information
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NPI Number | 1730312653
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Entity Type | Organization
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Legal Business Name | IDA'S HOMECARE AGENCY INC.
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Dates
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Enumeration Date | 08/26/2009
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 37 W 39TH ST SUITE 705
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City | NEW YORK
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State | NY
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Zip | 10018-3886
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Country | US
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Telephone | 212-719-5504
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Fax | 212-719-5427
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Provider Business Mailing Address
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Address Line | 37 W 39TH ST SUITE 705
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City | NEW YORK
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State | NY
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Zip | 10018-3886
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Country | US
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Telephone | 212-719-5504
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Fax | 212-719-5427
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JAMIL ABDUL-KAREEM
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Credential |
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Telephone | 212-719-5504
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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 | 9560L001
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License Number State | NY
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