Provider Demographics
NPI:1598828485
Name:PRESTIGE HOME ATTENDANT INC
Entity Type:Organization
Organization Name:PRESTIGE HOME ATTENDANT INC
Other - Org Name:ALL SEASON HOME ATTENDANT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ESTRELLA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:212-334-5480
Mailing Address - Street 1:377 BROADWAY
Mailing Address - Street 2:2ND FLOOR FRONT
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013
Mailing Address - Country:US
Mailing Address - Phone:212-334-5480
Mailing Address - Fax:212-334-5576
Practice Address - Street 1:377 BROADWAY
Practice Address - Street 2:2ND FLOOR FRONT
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013
Practice Address - Country:US
Practice Address - Phone:212-334-5480
Practice Address - Fax:212-334-5576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0834L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health