1962898247 NPI number — BIG APPLE HOMECARE AGENCY INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962898247 NPI number — BIG APPLE HOMECARE AGENCY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BIG APPLE HOMECARE AGENCY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962898247
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4301 GLENWOOD RD
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11210-2028
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-629-8732
Provider Business Mailing Address Fax Number:
718-444-1582

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4301 GLENWOOD RD
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11210-2028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-629-8732
Provider Business Practice Location Address Fax Number:
718-444-1582
Provider Enumeration Date:
04/13/2015

Additional Information

Authorized Official

Authorized Official Last Name:
MORD
Authorized Official First Name:
SIMON
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
718-629-8732

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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