Provider Demographics
NPI:1952869695
Name:CAREAIDE DIRECT, LLC
Entity Type:Organization
Organization Name:CAREAIDE DIRECT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRISHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-214-7756
Mailing Address - Street 1:2368 ADAM CLAYTON POWELL BLVD SUITE 1F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10030
Mailing Address - Country:US
Mailing Address - Phone:646-684-3092
Mailing Address - Fax:646-684-3119
Practice Address - Street 1:2368 ADAM CLAYTON POWELL BLVD SUITE 1F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10030
Practice Address - Country:US
Practice Address - Phone:646-684-3092
Practice Address - Fax:646-684-3119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04716932Medicaid