MEDICARE: PARKSHORE HOME 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	251E00000X	Home Health Agency	1190L001	NY

General Provider Information

NPI Number	:	1730278409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARKSHORE HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	3044 CONEY ISLAND AVENUE
Second Line	:	4TH FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11235
Country	:	US
Telephone Number	:	718-649-3670
Fax Number	:	718-649-3671

Provider Business Practice Location Address
First Line	:	3044 CONEY ISLAND AVE
Second Line	:	4TH FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5660
Country	:	US
Telephone Number	:	718-649-3670
Fax Number	:	718-649-3671

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. EILEEN PARENTI
Credential	:	BSN, RN
Telephone Number	:	718-649-3670

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	08/01/2013

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