Basic Information
Provider Information
NPI: 1396000311
EntityType: 2
ReplacementNPI:  
OrganizationName: BAYADA HOME HEALTH CARE, INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 101 EXECUTIVE DR
Address2:  
City: MOORESTOWN
State: NJ
PostalCode: 080574236
CountryCode: US
TelephoneNumber: 8567784400
FaxNumber: 8567784103
Practice Location
Address1: 300 MAIN ST
Address2: 7TH FLOOR
City: STAMFORD
State: CT
PostalCode: 069013032
CountryCode: US
TelephoneNumber: 2033253500
FaxNumber: 2033253900
Other Information
ProviderEnumerationDate: 07/05/2012
LastUpdateDate: 07/05/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: FLANNERY
AuthorizedOfficialFirstName: STEPHEN
AuthorizedOfficialMiddleName: P.
AuthorizedOfficialTitleorPosition: DIRECTOR OF BILLING & COLLECTIONS
AuthorizedOfficialTelephone: 8567784400
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: BAYADA HOME HEALTH CARE, INC.
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X  Y AgenciesHome Health 

No ID Information.


Home