MEDICARE: FEGS HOME ATTENDANT SERVICES, 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	9659L001	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619047131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FEGS HOME ATTENDANT SERVICES, INC.

Provider Business Mailing Address
First Line	:	424 E 147TH ST
Second Line	:	4TH FL
City	:	BRONX
State	:	NY
Zip	:	10455-4104
Country	:	US
Telephone Number	:	212-491-6000
Fax Number	:	212-369-2337

Provider Business Practice Location Address
First Line	:	424 E 147TH ST
Second Line	:	4TH FL
City	:	BRONX
State	:	NY
Zip	:	10455-4104
Country	:	US
Telephone Number	:	212-491-6000
Fax Number	:	212-369-2337

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. DORIS SPENCER
Credential	:	NURSE
Telephone Number	:	212-491-6000

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	05/11/2011

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