Basic Information
| Provider Information | |||||||||
| NPI: | 1891703369 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | LONG ISLAND JEWISH HOME HEALTH AGENCY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 972 BRUSH HOLLOW RD | ||||||||
| Address2: | 5TH FLOOR FINANCE ATTN: WILLIAM J. FUCHS | ||||||||
| City: | WESTBURY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115901740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5168766000 | ||||||||
| FaxNumber: | 5168766600 | ||||||||
| Practice Location | |||||||||
| Address1: | 270-05 76 AVE | ||||||||
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| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11040 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5168766000 | ||||||||
| FaxNumber: | 5168766600 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SHAPIRO | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | S. | ||||||||
| AuthorizedOfficialTitleorPosition: | SENOIR VICE PRESIDENT & CFO | ||||||||
| AuthorizedOfficialTelephone: | 5164658162 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | 7003004H | NY | Y | Agencies | Home Health |
No ID Information.