Provider Demographics
NPI:1598256232
Name:COMPANION CARE OF NEW YORK
Entity Type:Organization
Organization Name:COMPANION CARE OF NEW YORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LACHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-374-1218
Mailing Address - Street 1:525 HICKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5423
Mailing Address - Country:US
Mailing Address - Phone:516-374-1218
Mailing Address - Fax:516-374-1208
Practice Address - Street 1:405 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1906
Practice Address - Country:US
Practice Address - Phone:516-374-1218
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04733033251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04733033Medicaid