Provider Demographics
NPI:1619384146
Name:CITICARE,LLC
Entity Type:Organization
Organization Name:CITICARE,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHRAGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:646-423-2565
Mailing Address - Street 1:3000 OCEAN PKWY
Mailing Address - Street 2:SUITE 12M
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-8374
Mailing Address - Country:US
Mailing Address - Phone:646-423-2565
Mailing Address - Fax:
Practice Address - Street 1:3000 OCEAN PKWY
Practice Address - Street 2:SUITE 12M
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8374
Practice Address - Country:US
Practice Address - Phone:646-423-2565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No251E00000XAgenciesHome Health
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies