MEDICARE: EMPYREAN TEAM H-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	174200000X	Meals Provider
2	251300000X	Local Education Agency (LEA)
3	251K00000X	Public Health or Welfare Agency
4	251T00000X	PACE Provider Organization
5	305R00000X	Preferred Provider Organization

General Provider Information

NPI Number	:	1952057051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPYREAN TEAM H-C

Provider Business Mailing Address
First Line	:	699 WINTHROP ST APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-1808
Country	:	US
Telephone Number	:	718-701-1586
Fax Number	:	718-701-1295

Provider Business Practice Location Address
First Line	:	699 WINTHROP ST APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-1808
Country	:	US
Telephone Number	:	718-701-1586
Fax Number	:	718-701-1295

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DARLINE ETIENNE
Credential	:	RN
Telephone Number	:	718-701-1586

Provider Enumeration Date	:	02/28/2022
Last Update Date	:	02/28/2022

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Directions to “EMPYREAN TEAM H-C ” Practice Location

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