MEDICARE: STARLIGHT HOME CARE AGENCY, INC

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	HP0153400	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033370317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STARLIGHT HOME CARE AGENCY, INC

Provider Business Mailing Address
First Line	:	160 PEHLE AVE STE 203
Second Line	:
City	:	SADDLE BROOK
State	:	NJ
Zip	:	07663-5227
Country	:	US
Telephone Number	:	201-836-0500
Fax Number	:	201-836-5301

Provider Business Practice Location Address
First Line	:	160 PEHLE AVE STE 203
Second Line	:
City	:	SADDLE BROOK
State	:	NJ
Zip	:	07663-5227
Country	:	US
Telephone Number	:	201-836-0500
Fax Number	:	201-836-5301

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	VICTORIA ZATULOVSKY
Credential	:
Telephone Number	:	201-836-0500

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	03/14/2023

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