MEDICARE: MAES HOME CAREAGENCY 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		NY

General Provider Information

NPI Number	:	1891974739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAES HOME CAREAGENCY INC.

Provider Business Mailing Address
First Line	:	21441 JAMAICA AVE
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11428-1733
Country	:	US
Telephone Number	:	718-217-4111
Fax Number	:	718-217-4447

Provider Business Practice Location Address
First Line	:	21441 JAMAICA AVE
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11428-1733
Country	:	US
Telephone Number	:	718-217-4111
Fax Number	:	718-217-4447

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. VERNICE SAMUELS
Credential	:
Telephone Number	:	718-723-1695

Provider Enumeration Date	:	10/29/2007
Last Update Date	:	07/21/2022

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