MEDICARE: HOME FAMILY CARE, 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

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	:	1427692326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME FAMILY CARE, INC

Provider Business Mailing Address
First Line	:	3051 BRIGHTON 3RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7457
Country	:	US
Telephone Number	:	917-570-2850
Fax Number	:

Provider Business Practice Location Address
First Line	:	3051 BRIGHTON 3RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7457
Country	:	US
Telephone Number	:	917-570-2850
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALEXANDER KISELEV
Credential	:
Telephone Number	:	917-570-2850

Provider Enumeration Date	:	11/04/2019
Last Update Date	:	11/04/2019

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