Provider Demographics
NPI:1265761191
Name:MZL HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:MZL HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-575-9090
Mailing Address - Street 1:1819 EAST 13TH STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2870
Mailing Address - Country:US
Mailing Address - Phone:718-575-9090
Mailing Address - Fax:718-575-9099
Practice Address - Street 1:475 EAST MAIN STREET
Practice Address - Street 2:SUITE 216
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772
Practice Address - Country:US
Practice Address - Phone:631-699-2160
Practice Address - Fax:631-699-2151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-24
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1729L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1729L001OtherNEW YORK STATE DEPARTMENT OF HEALTH