Provider Demographics
NPI:1710467840
Name:COVENANT CARE OF NEW YORK LLC
Entity Type:Organization
Organization Name:COVENANT CARE OF NEW YORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTSIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-505-8125
Mailing Address - Street 1:P.O BOX 233
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533
Mailing Address - Country:US
Mailing Address - Phone:845-505-8125
Mailing Address - Fax:845-592-1734
Practice Address - Street 1:1 RIDGE ROAD
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533
Practice Address - Country:US
Practice Address - Phone:845-505-8215
Practice Address - Fax:845-592-1734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health