Provider Demographics
NPI:1770294589
Name:DORSAIN'S FAMILY CARE
Entity type:Organization
Organization Name:DORSAIN'S FAMILY CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DORSAIN
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:631-295-0397
Mailing Address - Street 1:2705 EAGLE AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11763-2054
Mailing Address - Country:US
Mailing Address - Phone:631-295-0397
Mailing Address - Fax:
Practice Address - Street 1:2705 EAGLE AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-2054
Practice Address - Country:US
Practice Address - Phone:631-295-0397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty