MEDICARE: PEYU HEALTH CARE 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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1588216717
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEYU HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	1538 E 35TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3439
Country	:	US
Telephone Number	:	347-742-8694
Fax Number	:

Provider Business Practice Location Address
First Line	:	1835 WILSON ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33020-2725
Country	:	US
Telephone Number	:	954-921-4059
Fax Number	:

Authorized Official
Title or Position	:	VP
Name	:	MOSHE SOSKIN
Credential	:
Telephone Number	:	347-742-8694

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	07/09/2019

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Directions to “PEYU HEALTH CARE LLC ” Practice Location

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