Provider Demographics
NPI:1033248638
Name:CITYWIDE HOMECARE MANAGEMENT CORP.
Entity Type:Organization
Organization Name:CITYWIDE HOMECARE MANAGEMENT CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:KRUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-429-1919
Mailing Address - Street 1:11 RAMAPO RD
Mailing Address - Street 2:
Mailing Address - City:GARNERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10923-1709
Mailing Address - Country:US
Mailing Address - Phone:845-429-1919
Mailing Address - Fax:845-634-2103
Practice Address - Street 1:11 RAMAPO RD
Practice Address - Street 2:
Practice Address - City:GARNERVILLE
Practice Address - State:NY
Practice Address - Zip Code:10923-1709
Practice Address - Country:US
Practice Address - Phone:845-429-1919
Practice Address - Fax:845-634-2103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0896350001Medicare ID - Type UnspecifiedDURABLE MEDICAL EQUIPMENT