# LONG ISLAND PEDIATRIC HOMECARE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TRIBORO HOMECARE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1689039513
- **Legal business name:** TRIBORO HOMECARE
- **Authorized official:** MISS MEAGHAN MACDONALD (NURSE)
- **Authorized official phone:** (631) 671-5191

## Contact information

- **Practice address:** 389 THIRTY THIRD STREET, LINDENHURST, NY 11757
- **Practice address phone:** (631) 671-5191
- **Mailing address:** 389 33RD ST, LINDENHURST, NY 11757-3240

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 705878-1 | NY | Yes |

## Other

- **Enumeration date:** 12/18/2015
- **Last updated:** 12/18/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1234567891011121314 | — | NY |