Provider Demographics
NPI:1548602378
Name:QUEENS HOMECARE AGENCY
Entity Type:Organization
Organization Name:QUEENS HOMECARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-925-2180
Mailing Address - Street 1:2 E BROADWAY STE 808
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-1073
Mailing Address - Country:US
Mailing Address - Phone:212-925-2180
Mailing Address - Fax:
Practice Address - Street 1:2 E BROADWAY STE 808
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-1073
Practice Address - Country:US
Practice Address - Phone:212-925-2180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health