Provider Demographics
NPI:1518677533
Name:MEDSTAFF HEALTH AGENCY, LLC
Entity Type:Organization
Organization Name:MEDSTAFF HEALTH AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARYJANE
Authorized Official - Middle Name:OGECHUKWU
Authorized Official - Last Name:NWAKOR
Authorized Official - Suffix:
Authorized Official - Credentials:DNP,RN
Authorized Official - Phone:516-784-1906
Mailing Address - Street 1:3504 HOWARD BLVD
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-5155
Mailing Address - Country:US
Mailing Address - Phone:516-784-1906
Mailing Address - Fax:
Practice Address - Street 1:3504 HOWARD BLVD
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-5155
Practice Address - Country:US
Practice Address - Phone:516-784-1906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care