Provider Demographics
NPI:1205348828
Name:UNIFIED PROFESSIONAL CARE, LLC
Entity type:Organization
Organization Name:UNIFIED PROFESSIONAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVOSELOVA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:917-400-8884
Mailing Address - Street 1:10214 ROCKAWAY BEACH BLVD
Mailing Address - Street 2:3C
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694-2743
Mailing Address - Country:US
Mailing Address - Phone:917-400-8884
Mailing Address - Fax:
Practice Address - Street 1:10214 ROCKAWAY BEACH BLVD
Practice Address - Street 2:3C
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-2743
Practice Address - Country:US
Practice Address - Phone:917-400-8884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-05
Last Update Date:2017-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care