MEDICARE: ZABETH CARE HEALTH AGENCY 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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1710620984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZABETH CARE HEALTH AGENCY LLC

Provider Business Mailing Address
First Line	:	4013 BELL AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2305
Country	:	US
Telephone Number	:	191-747-6535
Fax Number	:

Provider Business Practice Location Address
First Line	:	1434 WILLIAMSBRIDGE RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2507
Country	:	US
Telephone Number	:	917-476-5357
Fax Number	:

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	JOY CHRIS-ONUOHA
Credential	:	FNP
Telephone Number	:	191-747-6535

Provider Enumeration Date	:	04/15/2022
Last Update Date	:	04/15/2022

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