Provider Demographics
NPI:1801565247
Name:BAYSHORE HOME HEALTHCARE, INC .
Entity type:Organization
Organization Name:BAYSHORE HOME HEALTHCARE, INC .
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-647-9020
Mailing Address - Street 1:1111 44TH DR
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5273
Mailing Address - Country:US
Mailing Address - Phone:631-513-0607
Mailing Address - Fax:631-647-9020
Practice Address - Street 1:1111 44TH DR
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-5273
Practice Address - Country:US
Practice Address - Phone:631-513-0607
Practice Address - Fax:631-647-9020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health