Provider Demographics
NPI:1912227240
Name:EMERALD HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:EMERALD HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN/ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:212-829-5516
Mailing Address - Street 1:445 PARK AVE
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2606
Mailing Address - Country:US
Mailing Address - Phone:212-829-5516
Mailing Address - Fax:212-202-4051
Practice Address - Street 1:445 PARK AVE
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2606
Practice Address - Country:US
Practice Address - Phone:212-829-5516
Practice Address - Fax:212-202-4051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY526438251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care