Provider Demographics
NPI:1700850971
Name:PCI HOME CARE GROUP INC
Entity Type:Organization
Organization Name:PCI HOME CARE GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ZENAIDA
Authorized Official - Middle Name:BOCANEGRA
Authorized Official - Last Name:MAGLANOC
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:718-884-7800
Mailing Address - Street 1:336 W 263RD ST
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1106
Mailing Address - Country:US
Mailing Address - Phone:718-884-7800
Mailing Address - Fax:718-549-2857
Practice Address - Street 1:336 W 263RD ST
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:NY
Practice Address - Zip Code:10471-1106
Practice Address - Country:US
Practice Address - Phone:718-884-7800
Practice Address - Fax:718-549-2857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0974L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02661383Medicaid