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General NPI Number Information
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NPI Number | 1902324163
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Entity Type | Organization
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Legal Business Name | VIP HOMECARE INC
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Dates
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Enumeration Date | 09/07/2017
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Last Update Date | 08/02/2018
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Provider Practice Location Address
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Address Line | 1858 CORNAGA AVE FL 2
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691
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Country | US
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Telephone | 845-570-3821
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Fax |
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Provider Business Mailing Address
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Address Line | 634 VAN DAM ST
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City | VALLEY STREAM
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State | NY
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Zip | 11581-3537
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Country | US
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Telephone | 845-570-3821
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | YAAKOV M JACOBOVITCH
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Credential |
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Telephone | 845-570-3821
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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 |
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License Number State |
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