Provider Demographics
NPI:1164645586
Name:ALICE KRAWCYK, INC.
Entity Type:Organization
Organization Name:ALICE KRAWCYK, INC.
Other - Org Name:HAND IN HAND CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:DARLENE
Authorized Official - Last Name:KRAWCYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-342-4787
Mailing Address - Street 1:25 MYRTLE AVE.
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940
Mailing Address - Country:US
Mailing Address - Phone:845-342-4787
Mailing Address - Fax:845-341-1023
Practice Address - Street 1:25 MYRTLE AVE.
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940
Practice Address - Country:US
Practice Address - Phone:845-342-4787
Practice Address - Fax:845-341-1023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0652L001251E00000X
NY0652I001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02060084Medicaid