Provider Demographics
NPI:1629619432
Name:FAMILY CARE NYC LLC
Entity Type:Organization
Organization Name:FAMILY CARE NYC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KINJAL
Authorized Official - Middle Name:T
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:347-484-6858
Mailing Address - Street 1:7840 164TH ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1208
Mailing Address - Country:US
Mailing Address - Phone:347-484-6858
Mailing Address - Fax:
Practice Address - Street 1:7840 164TH ST APT 2A
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1208
Practice Address - Country:US
Practice Address - Phone:347-484-6858
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05503168Medicaid