Provider Demographics
NPI:1134455942
Name:GREATCARE INC
Entity type:Organization
Organization Name:GREATCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-226-5679
Mailing Address - Street 1:407 PARK AVE S
Mailing Address - Street 2:#6F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8414
Mailing Address - Country:US
Mailing Address - Phone:646-226-5679
Mailing Address - Fax:212-419-1284
Practice Address - Street 1:110 W 34TH ST
Practice Address - Street 2:SUITE 806
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2115
Practice Address - Country:US
Practice Address - Phone:646-267-5677
Practice Address - Fax:212-419-1284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-29
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1475-L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health