Provider Demographics
NPI:1154669133
Name:CENTERLIGHT CERTIFIED HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:CENTERLIGHT CERTIFIED HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-519-4032
Mailing Address - Street 1:1250 WATERS PL
Mailing Address - Street 2:SUITE 602
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2720
Mailing Address - Country:US
Mailing Address - Phone:718-519-4022
Mailing Address - Fax:718-519-5098
Practice Address - Street 1:596 PROSPECT PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-4205
Practice Address - Country:US
Practice Address - Phone:718-362-1453
Practice Address - Fax:718-638-9124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health