Basic Information
| Provider Information | |||||||||
| NPI: | 1639424559 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BAYADA HOME HEALTH CARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 826 ELLIS AVE | ||||||||
| Address2: | |||||||||
| City: | NEWTOWN SQUARE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190733906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103562872 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1023 E BALTIMORE PIKE | ||||||||
| Address2: | SUITE 303 | ||||||||
| City: | MEDIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190635126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6108911636 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/17/2012 | ||||||||
| LastUpdateDate: | 07/17/2012 | ||||||||
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| AuthorizedOfficialLastName: | CONDI | ||||||||
| AuthorizedOfficialFirstName: | SUSAN | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | OCCUPATIONAL THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 6108911636 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | OTR/L | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | OC000960L | PA | Y | Agencies | Home Health |
No ID Information.