Provider Demographics
NPI:1740754746
Name:JUST CARE, LLC. CDPAP-FI
Entity Type:Organization
Organization Name:JUST CARE, LLC. CDPAP-FI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DMITRY
Authorized Official - Middle Name:
Authorized Official - Last Name:TSEPENYUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-332-0280
Mailing Address - Street 1:2101 AVENUE Z
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-2858
Mailing Address - Country:US
Mailing Address - Phone:718-332-0280
Mailing Address - Fax:
Practice Address - Street 1:2101 AVENUE Z
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-2858
Practice Address - Country:US
Practice Address - Phone:718-332-0280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYFI670OtherNYS DOH- CDPAP-FI