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General NPI Number Information
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NPI Number | 1972821130
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Entity Type | Organization
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Legal Business Name | MARGARET ULTRA HOME CARE INC
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Dates
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Enumeration Date | 05/12/2010
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Last Update Date | 05/12/2010
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Provider Practice Location Address
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Address Line | 34 BEACH ST
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2702
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Country | US
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Telephone | 718-815-8089
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Fax |
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Provider Business Mailing Address
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Address Line | 29 S MICHIGAN AVE
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City | KENILWORTH
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State | NJ
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Zip | 07033-1742
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Country | US
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Telephone | 484-222-1847
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | MRS. JESSICA HERNANDEZ
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Credential |
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Telephone | 484-222-1847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 283710-1
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License Number State | NY
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