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General NPI Number Information
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NPI Number | 1841312519
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Entity Type | Organization
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Legal Business Name | ABC HEALTH SERVICE REGISTRY, INC.
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 13340 37TH AVE APT 2
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City | FLUSHING
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State | NY
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Zip | 11354-4456
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Country | US
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Telephone | 718-359-2284
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Fax | 718-359-3252
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Provider Business Mailing Address
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Address Line | 4278 MAIN ST
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City | FLUSHING
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State | NY
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Zip | 11355-4723
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Country | US
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Telephone | 718-359-2284
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Fax | 718-359-3252
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. JENNY CHAN FUNG CHAN
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Credential | MPA
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Telephone | 718-359-2284
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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 | 9137L001
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License Number State | NY
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