Provider Demographics
NPI:1922395904
Name:SENIORBRIDGE FAMILY COMPANIES (NY), INC
Entity Type:Organization
Organization Name:SENIORBRIDGE FAMILY COMPANIES (NY), INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CLINICAL QUALITY
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-258-7709
Mailing Address - Street 1:845 3RD AVE
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-6601
Mailing Address - Country:US
Mailing Address - Phone:212-994-6100
Mailing Address - Fax:212-994-4260
Practice Address - Street 1:845 3RD AVE
Practice Address - Street 2:7TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-6601
Practice Address - Country:US
Practice Address - Phone:212-994-6100
Practice Address - Fax:212-994-4260
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUMANA AT HOME, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-29
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
NY1726L001253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health