Provider Demographics
NPI:1184215881
Name:HOME AIDE SERVICE OF EASTERN NEW YORK, INC.
Entity Type:Organization
Organization Name:HOME AIDE SERVICE OF EASTERN NEW YORK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:T
Authorized Official - Last Name:MAZZACCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-270-1310
Mailing Address - Street 1:433 RIVER ST STE 3000
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-2250
Mailing Address - Country:US
Mailing Address - Phone:518-274-6200
Mailing Address - Fax:518-274-1829
Practice Address - Street 1:433 RIVER ST STE 3000
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2250
Practice Address - Country:US
Practice Address - Phone:518-274-6200
Practice Address - Fax:518-274-1829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion