MEDICARE: OFF THE MAP 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

General Provider Information

NPI Number	:	1740890243
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OFF THE MAP LLC

Provider Business Mailing Address
First Line	:	200 NUNDA AVE APT 2L
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-6679
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 NUNDA AVE APT 2L
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-6679
Country	:	US
Telephone Number	:	201-912-6256
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MOHAMED ELDIB
Credential	:
Telephone Number	:	201-912-6256

Provider Enumeration Date	:	08/09/2020
Last Update Date	:	08/09/2020

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Directions to “OFF THE MAP LLC ” Practice Location

Language	Start Address	Practice Location

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