Provider Demographics
NPI:1013398536
Name:FAVORITE HEALTHCARE STAFFING
Entity Type:Organization
Organization Name:FAVORITE HEALTHCARE STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGBOGU SANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-346-9708
Mailing Address - Street 1:625 MAIN ST APT 1432
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044-0036
Mailing Address - Country:US
Mailing Address - Phone:917-346-9708
Mailing Address - Fax:
Practice Address - Street 1:625 MAIN ST APT 1432
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10044-0036
Practice Address - Country:US
Practice Address - Phone:917-346-9708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAVORITE HEALTHCARE STAFFING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2813873140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1223794258Medicare PIN