Provider Demographics
NPI:1811654817
Name:UNITED PEDIATRIC HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:UNITED PEDIATRIC HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GENNADY
Authorized Official - Middle Name:
Authorized Official - Last Name:KATSNELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-415-6167
Mailing Address - Street 1:100 E SYBELIA AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4758
Mailing Address - Country:US
Mailing Address - Phone:718-415-6167
Mailing Address - Fax:813-685-8973
Practice Address - Street 1:100 E SYBELIA AVE STE 305
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4758
Practice Address - Country:US
Practice Address - Phone:718-415-6167
Practice Address - Fax:813-685-8973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-24
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health