Provider Demographics
NPI:1033660543
Name:CAREPRO OF BIG APPLE, LLC
Entity Type:Organization
Organization Name:CAREPRO OF BIG APPLE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELUSHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-717-7750
Mailing Address - Street 1:1712 KINGS HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229
Mailing Address - Country:US
Mailing Address - Phone:718-717-7750
Mailing Address - Fax:718-717-7463
Practice Address - Street 1:1712 KINGS HWY
Practice Address - Street 2:STE 100
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:718-717-7750
Practice Address - Fax:718-717-7463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-19
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251B00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04471261Medicaid