Provider Demographics
NPI:1730312653
Name:IDA'S HOMECARE AGENCY INC.
Entity Type:Organization
Organization Name:IDA'S HOMECARE AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDUL-KAREEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-719-5504
Mailing Address - Street 1:37 W 39TH ST
Mailing Address - Street 2:SUITE 705
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-3886
Mailing Address - Country:US
Mailing Address - Phone:212-719-5504
Mailing Address - Fax:212-719-5427
Practice Address - Street 1:37 W 39TH ST
Practice Address - Street 2:SUITE 705
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-3886
Practice Address - Country:US
Practice Address - Phone:212-719-5504
Practice Address - Fax:212-719-5427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9560L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health