Provider Demographics
NPI:1093254526
Name:CUPID HOMECARE AGENCY
Entity Type:Organization
Organization Name:CUPID HOMECARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:914-602-6561
Mailing Address - Street 1:2861 HARRINGTON AVE
Mailing Address - Street 2:APT 2
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-5955
Mailing Address - Country:US
Mailing Address - Phone:914-602-6561
Mailing Address - Fax:
Practice Address - Street 1:2861 HARRINGTON AVE
Practice Address - Street 2:APT 2
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5955
Practice Address - Country:US
Practice Address - Phone:914-602-6561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care