Provider Demographics
NPI:1215367214
Name:FAITH FIRST NURSING SERVICES
Entity Type:Organization
Organization Name:FAITH FIRST NURSING SERVICES
Other - Org Name:GINA M FACCIOLI RN
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FACCIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:845-642-1522
Mailing Address - Street 1:860 BELLEVILLE DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-2616
Mailing Address - Country:US
Mailing Address - Phone:845-642-1522
Mailing Address - Fax:
Practice Address - Street 1:860 BELLEVILLE DR
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-2616
Practice Address - Country:US
Practice Address - Phone:845-642-1522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY562207251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health