Provider Demographics
NPI:1104394634
Name:GENESA HOME HEALTHCARE & COMPANION AGENCY LLC
Entity Type:Organization
Organization Name:GENESA HOME HEALTHCARE & COMPANION AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MASSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORNEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-570-5063
Mailing Address - Street 1:568 LINDERMAN AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-8602
Mailing Address - Country:US
Mailing Address - Phone:845-616-2842
Mailing Address - Fax:845-514-2101
Practice Address - Street 1:164 LINCOLN HWY STE 202
Practice Address - Street 2:
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-1000
Practice Address - Country:US
Practice Address - Phone:845-616-2842
Practice Address - Fax:845-514-2101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-02
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care