Provider Demographics
NPI:1629336706
Name:NOVEL HOME HEALTH CARE SERVICES OF NEW YORK CORP.
Entity Type:Organization
Organization Name:NOVEL HOME HEALTH CARE SERVICES OF NEW YORK CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLEG
Authorized Official - Middle Name:
Authorized Official - Last Name:DADASHEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-763-1012
Mailing Address - Street 1:247 PROSPECT AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-8403
Mailing Address - Country:US
Mailing Address - Phone:347-763-1012
Mailing Address - Fax:347-763-0542
Practice Address - Street 1:247 PROSPECT AVE STE 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-8403
Practice Address - Country:US
Practice Address - Phone:347-763-1012
Practice Address - Fax:347-763-0542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1865L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health