MEDICARE: JOYFUL NY LLC

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	2104L001	NY

General Provider Information

NPI Number	:	1043672769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOYFUL NY LLC

Provider Business Mailing Address
First Line	:	1344 MIDDLE COUNTRY RD
Second Line	:
City	:	CENTEREACH
State	:	NY
Zip	:	11720-3583
Country	:	US
Telephone Number	:	631-737-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1344 MIDDLE COUNTRY RD
Second Line	:
City	:	CENTEREACH
State	:	NY
Zip	:	11720-3583
Country	:	US
Telephone Number	:	631-737-1000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOY MEKKATTE
Credential	:
Telephone Number	:	631-737-1000

Provider Enumeration Date	:	03/22/2016
Last Update Date	:	03/22/2016

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Directions to “JOYFUL NY LLC ” Practice Location

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