Provider Demographics
NPI:1841536919
Name:MR HOMECARE AGENCY OF NY INC
Entity type:Organization
Organization Name:MR HOMECARE AGENCY OF NY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RABINOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-338-6300
Mailing Address - Street 1:251 E 5TH ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2403
Mailing Address - Country:US
Mailing Address - Phone:718-338-6300
Mailing Address - Fax:347-710-1969
Practice Address - Street 1:150 OCEAN PKWY
Practice Address - Street 2:C102
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2481
Practice Address - Country:US
Practice Address - Phone:718-338-6300
Practice Address - Fax:347-710-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1802L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health