Provider Demographics
NPI:1629311683
Name:VISITING NURSE ASSOCIATION OF ALBANY HOME CARE CORPORATION
Entity type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF ALBANY HOME CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DICICCO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA-HCM, BSN, BA
Authorized Official - Phone:203-627-4170
Mailing Address - Street 1:28 COLVIN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-1101
Mailing Address - Country:US
Mailing Address - Phone:518-694-9907
Mailing Address - Fax:
Practice Address - Street 1:28 COLVIN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-1101
Practice Address - Country:US
Practice Address - Phone:518-694-9907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY298963251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1316918063Medicaid