Organization
CENTERCARE CDPAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRIS HE RN (ADMINISTRATOR)
(347) 625-8002
Entity
Organization
Contact information
Practice address
5743 263RD ST, LITTLE NECK, NY 11362-2228
(718) 902-1386
Mailing address
5743 263RD ST, LITTLE NECK, NY 11362-2228
(718) 902-1386
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04705166
—
NY
Enumeration date
05/17/2017
Last updated
07/21/2022
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