Provider Demographics
NPI:1548596497
Name:CRITICAL CARE NURSING AGENCY, LLC
Entity Type:Organization
Organization Name:CRITICAL CARE NURSING AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO , PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANILKUMAR
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-930-4553
Mailing Address - Street 1:94 PHILLIPS DR
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2432
Mailing Address - Country:US
Mailing Address - Phone:908-930-4553
Mailing Address - Fax:
Practice Address - Street 1:1111 MARCUS AVE
Practice Address - Street 2:SUITE # 100
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1034
Practice Address - Country:US
Practice Address - Phone:908-930-4553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1843-L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health