Provider Demographics
NPI:1942626270
Name:JOS-EL CARE AGENCY
Entity Type:Organization
Organization Name:JOS-EL CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHIRLEEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:POLYNICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-357-6527
Mailing Address - Street 1:13 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-6003
Mailing Address - Country:US
Mailing Address - Phone:516-823-0739
Mailing Address - Fax:
Practice Address - Street 1:13 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-6003
Practice Address - Country:US
Practice Address - Phone:516-823-0739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY317824251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY317824OtherLPN LISENCE