Provider Demographics
NPI:1518476597
Name:METROPOLITAN HOMECARE WAY, INC.
Entity Type:Organization
Organization Name:METROPOLITAN HOMECARE WAY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:OLEVSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-336-1180
Mailing Address - Street 1:380 88TH STREET
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-8152
Mailing Address - Country:US
Mailing Address - Phone:718-336-1180
Mailing Address - Fax:718-336-1195
Practice Address - Street 1:380 88TH STREET
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-8152
Practice Address - Country:US
Practice Address - Phone:718-336-1180
Practice Address - Fax:718-336-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-22
Last Update Date:2017-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1382L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04347971Medicaid