Provider Demographics
NPI:1992380760
Name:MAERO HOMECARE AGENCY LLC
Entity Type:Organization
Organization Name:MAERO HOMECARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MAERO
Authorized Official - Middle Name:
Authorized Official - Last Name:OMOIRAWUA
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:347-265-9335
Mailing Address - Street 1:2520 RADCLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-4206
Mailing Address - Country:US
Mailing Address - Phone:646-642-1611
Mailing Address - Fax:
Practice Address - Street 1:2520 RADCLIFF AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-4206
Practice Address - Country:US
Practice Address - Phone:646-642-1611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-13
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC2100XNursing Service ProvidersRegistered NurseContinence CareGroup - Multi-Specialty