MEDICARE: S & A UNIFIED HOME 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	1192L001	NY

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	:	1457562811
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S & A UNIFIED HOME CARE, INC.

Provider Business Mailing Address
First Line	:	2729 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5004
Country	:	US
Telephone Number	:	718-980-6100
Fax Number	:	718-873-9311

Provider Business Practice Location Address
First Line	:	2729 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5004
Country	:	US
Telephone Number	:	718-980-6100
Fax Number	:	718-873-9311

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ANGELA MARDUKHAYEVA
Credential	:
Telephone Number	:	917-673-7541

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	05/12/2025

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