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General NPI Number Information
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NPI Number | 1730623752
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Entity Type | Organization
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Legal Business Name | OPTIMUM HOME CARE LLC
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Dates
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Enumeration Date | 12/09/2016
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Last Update Date | 12/09/2016
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Provider Practice Location Address
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Address Line | 41 UNION SQ W SUITE 617
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City | NEW YORK
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State | NY
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Zip | 10003-3236
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Country | US
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Telephone | 212-924-8418
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Fax |
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Provider Business Mailing Address
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Address Line | 41 UNION SQ W SUITE 617
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City | NEW YORK
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State | NY
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Zip | 10003-3236
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Country | US
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Telephone | 212-924-8418
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LORETA COLOMBO
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Credential | MS
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Telephone | 212-924-8418
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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 | 2234L001
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License Number State | NY
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