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General NPI Number Information
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NPI Number | 1992008015
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Entity Type | Organization
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Legal Business Name | BEACON ELDERCARE, INC
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Dates
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Enumeration Date | 12/11/2010
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Last Update Date | 12/11/2010
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Provider Practice Location Address
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Address Line | 6906 GRAND AVE SECOND FLOOR
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City | MASPETH
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State | NY
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Zip | 11378-1813
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Country | US
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Telephone | 718-406-9500
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Fax | 866-651-3635
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Provider Business Mailing Address
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Address Line | 19 HUDSON RD
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City | BELLEROSE VILLAGE
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State | NY
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Zip | 11001-4104
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Country | US
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Telephone | 516-775-8278
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Fax | 866-651-3635
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEPH DROP
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Credential |
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Telephone | 516-775-8278
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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 | 1476L001
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License Number State | NY
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