Provider Demographics
NPI:1164930681
Name:NJ SUNNY HOME CARE INC
Entity Type:Organization
Organization Name:NJ SUNNY HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VITALIY
Authorized Official - Middle Name:
Authorized Official - Last Name:SARKISYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-500-5075
Mailing Address - Street 1:1139 E JERSEY ST STE 605
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07201-2467
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1139 E JERSEY ST STE 605
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07201-2467
Practice Address - Country:US
Practice Address - Phone:929-500-5075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0269800251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health