MEDICARE: HOME MEDICAL CARE PC

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	136115	NY

General Provider Information

NPI Number	:	1669975033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME MEDICAL CARE PC

Provider Business Mailing Address
First Line	:	56 GRAND CENTRAL AVE
Second Line	:
City	:	AMITYVILLE
State	:	NY
Zip	:	11701-3749
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	56 GRAND CENTRAL AVE
Second Line	:
City	:	AMITYVILLE
State	:	NY
Zip	:	11701-3749
Country	:	US
Telephone Number	:	631-264-2788
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD LESLIE COVEN
Credential	:
Telephone Number	:	631-264-2788

Provider Enumeration Date	:	03/13/2018
Last Update Date	:	03/13/2018

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