Provider Demographics
NPI:1801189493
Name:GTD SERVICES INC
Entity Type:Organization
Organization Name:GTD SERVICES INC
Other - Org Name:BRIGHTSTAR OF NORTH SHORE NASSAU COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:NICKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-364-1951
Mailing Address - Street 1:25 RONALD LN
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3518
Mailing Address - Country:US
Mailing Address - Phone:516-364-1951
Mailing Address - Fax:
Practice Address - Street 1:25 RONALD LN
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3518
Practice Address - Country:US
Practice Address - Phone:516-364-1951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-16
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health