Provider Demographics
NPI:1558809673
Name:CDPAP HOME CARE SERVICE INC.
Entity Type:Organization
Organization Name:CDPAP HOME CARE SERVICE INC.
Other - Org Name:SUN STAR HOME CARE AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PYONG
Authorized Official - Middle Name:SUN
Authorized Official - Last Name:YUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-614-7000
Mailing Address - Street 1:142-18 38TH AVENUE
Mailing Address - Street 2:SUITE #CFD
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5554
Mailing Address - Country:US
Mailing Address - Phone:718-614-7000
Mailing Address - Fax:718-888-0025
Practice Address - Street 1:142-18 38TH AVENUE
Practice Address - Street 2:SUITE #CFD
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5554
Practice Address - Country:US
Practice Address - Phone:718-614-7000
Practice Address - Fax:718-888-0025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04692339Medicaid