Basic Information
Provider Information
NPI: 1124466255
EntityType: 2
ReplacementNPI:  
OrganizationName: BAYADA HOME HEALTH CARE, INC.
LastName:  
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Mailing Information
Address1: 101 EXECUTIVE DR
Address2:  
City: MOORESTOWN
State: NJ
PostalCode: 080574236
CountryCode: US
TelephoneNumber: 8567784400
FaxNumber: 8567784103
Practice Location
Address1: 80 WOLF RD
Address2: SUITE 308
City: ALBANY
State: NY
PostalCode: 122052608
CountryCode: US
TelephoneNumber: 5184375177
FaxNumber: 5184375110
Other Information
ProviderEnumerationDate: 06/11/2013
LastUpdateDate: 06/17/2013
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: FLANNERY
AuthorizedOfficialFirstName: STEPHEN
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AuthorizedOfficialTitleorPosition: DIRECTOR OF BILLING AND COLLECTIONS
AuthorizedOfficialTelephone: 8567784400
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: BAYADA HOME HEALTH CARE, INC.
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X  Y AgenciesHome Health 

No ID Information.


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