Provider Demographics
NPI:1114583267
Name:1ST HOME CARE OF NY CORP. (CDPAP)
Entity Type:Organization
Organization Name:1ST HOME CARE OF NY CORP. (CDPAP)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DILYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALITOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-523-4127
Mailing Address - Street 1:320 BERNARD DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-2220
Mailing Address - Country:US
Mailing Address - Phone:347-523-4127
Mailing Address - Fax:347-708-9089
Practice Address - Street 1:1601 GRAVESEND NECK RD STE 12A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4426
Practice Address - Country:US
Practice Address - Phone:347-523-4127
Practice Address - Fax:347-708-9089
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1ST HOME CARE OF NY CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-14
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health