MEDICARE: INFINITI HOME CARE INC

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	1316L001	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841476009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITI HOME CARE INC

Provider Business Mailing Address
First Line	:	116-55 QUEENS BLVD #224
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375
Country	:	US
Telephone Number	:	718-544-4488
Fax Number	:	718-544-4499

Provider Business Practice Location Address
First Line	:	11655 QUEENS BLVD SUITE 224
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-6527
Country	:	US
Telephone Number	:	718-544-4488
Fax Number	:	718-544-4499

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	OLEG PINKHASOV
Credential	:
Telephone Number	:	718-544-4488

Provider Enumeration Date	:	01/17/2008
Last Update Date	:	01/26/2017

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