Provider Demographics
NPI:1922512417
Name:NORTH OCEAN HOME CARE INC
Entity Type:Organization
Organization Name:NORTH OCEAN HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DO
Authorized Official - Prefix:
Authorized Official - First Name:ADEEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-730-1189
Mailing Address - Street 1:144 N OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-2004
Mailing Address - Country:US
Mailing Address - Phone:631-730-1189
Mailing Address - Fax:
Practice Address - Street 1:144 N OCEAN AVE
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-2004
Practice Address - Country:US
Practice Address - Phone:631-730-1189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY260863207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04485829Medicaid