Provider Demographics
NPI:1407355811
Name:CARELINK-CDPAP INC.
Entity Type:Organization
Organization Name:CARELINK-CDPAP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ENA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:516-358-1999
Mailing Address - Street 1:25 S TYSON AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2018
Mailing Address - Country:US
Mailing Address - Phone:516-358-1999
Mailing Address - Fax:
Practice Address - Street 1:188 MONTAGUE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3605
Practice Address - Country:US
Practice Address - Phone:718-488-8300
Practice Address - Fax:718-488-0845
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARELINK, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9310L001163W00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01435836Medicaid