MEDICARE: LOWER WEST SIDE HOUSEHOLD SERVICES CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0217L002	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1023471935
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOWER WEST SIDE HOUSEHOLD SERVICES CORP

Provider Business Mailing Address
First Line	:	225 DOLSON AVE STE 206A
Second Line	:
City	:	MIDDLETOWN
State	:	NY
Zip	:	10940-6570
Country	:	US
Telephone Number	:	212-307-7107
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 DOLSON AVE STE 206A
Second Line	:
City	:	MIDDLETOWN
State	:	NY
Zip	:	10940-6570
Country	:	US
Telephone Number	:	914-722-2467
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. LUCIA PONS
Credential	:
Telephone Number	:	212-307-7107

Provider Enumeration Date	:	03/30/2016
Last Update Date	:	12/01/2025

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Directions to “LOWER WEST SIDE HOUSEHOLD SERVICES CORP ” Practice Location

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