Provider Demographics
NPI:1396224481
Name:MAGIC HOME CARE FI LLC
Entity Type:Organization
Organization Name:MAGIC HOME CARE FI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GENNADY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-484-4900
Mailing Address - Street 1:250 AVENUE X
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-5940
Mailing Address - Country:US
Mailing Address - Phone:718-484-4900
Mailing Address - Fax:718-484-4899
Practice Address - Street 1:250 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5940
Practice Address - Country:US
Practice Address - Phone:718-484-4900
Practice Address - Fax:718-484-4899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2007L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health