Provider Demographics
NPI:1558503136
Name:MARY CARE LLC
Entity Type:Organization
Organization Name:MARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIR PERSON
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:VERITY
Authorized Official - Last Name:ATSISEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LPN
Authorized Official - Phone:347-590-6598
Mailing Address - Street 1:1860 LAFAYETTE AVE
Mailing Address - Street 2:1B
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2843
Mailing Address - Country:US
Mailing Address - Phone:646-457-7025
Mailing Address - Fax:347-590-6598
Practice Address - Street 1:1860 LAFAYETTE AVE
Practice Address - Street 2:1B
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2843
Practice Address - Country:US
Practice Address - Phone:646-457-7025
Practice Address - Fax:347-590-6598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-30
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5719924251E00000X
NY6357310251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health