MEDICARE: MCKAYLA HOMECARE

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	163WH0200X	Home Health Registered Nurse

General Provider Information

NPI Number	:	1639022262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCKAYLA HOMECARE

Provider Business Mailing Address
First Line	:	123 CLAREMONT AVE
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-4012
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 CLAREMONT AVE
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-4012
Country	:	US
Telephone Number	:	516-304-4492
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MAGDALA PERSIMONT
Credential	:
Telephone Number	:	516-304-4492

Provider Enumeration Date	:	02/14/2026
Last Update Date	:	02/14/2026

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