Provider Demographics
NPI:1700940079
Name:VISITING NURSE ASSOCIATION OF LONG ISLAND LTHHCP
Entity Type:Organization
Organization Name:VISITING NURSE ASSOCIATION OF LONG ISLAND LTHHCP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:ORAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KEENAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-739-1270
Mailing Address - Street 1:100 GARDEN CITY PLZ
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-3203
Mailing Address - Country:US
Mailing Address - Phone:516-739-1270
Mailing Address - Fax:516-739-3864
Practice Address - Street 1:100 GARDEN CITY PLZ
Practice Address - Street 2:SUITE 100
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-3203
Practice Address - Country:US
Practice Address - Phone:516-739-1270
Practice Address - Fax:516-739-3864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2905900L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2905900LMedicaid
NY337143Medicare ID - Type UnspecifiedMEDICARE ID NUMBER