Provider Demographics
NPI:1104383348
Name:OSPREY HOME HEALTH LLC
Entity Type:Organization
Organization Name:OSPREY HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GALINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEGUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-210-4240
Mailing Address - Street 1:646 ROUTE 18 NORTH
Mailing Address - Street 2:BLDG. A, SUITE 205
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3722
Mailing Address - Country:US
Mailing Address - Phone:732-210-4240
Mailing Address - Fax:
Practice Address - Street 1:646 ROUTE 18 NORTH
Practice Address - Street 2:BLDG. A, SUITE 205
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3722
Practice Address - Country:US
Practice Address - Phone:732-210-4240
Practice Address - Fax:732-210-4251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1427563741Medicaid
NJ1104383348OtherHOME HEALTH
NJHP0280000OtherLICENSE