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Organization

ST MARY'S COMMUNITY CARE PROFESSIONAL, CORP.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. FREDERIQUE ALTIDOR (MANAGER)
(718) 281-8688
Entity
Organization

Contact information

Practice address
9131 QUEENS BLVD, SUITE 201, ELMHURST, NY 11373-5555
(718) 819-2713
Mailing address
9131 QUEENS BLVD, SUITE 201, ELMHURST, NY 11373-5555
(718) 819-2713

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01783504
NY
Enumeration date
04/10/2007
Last updated
04/12/2013
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