Organization
MOHAWK VALLEY HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA L LAZAREK-LAQUAY RN (DIRECTOR OF PATIENT SERVICES)
(315) 624-8900
Entity
Organization
Contact information
Practice address
2521 SUNSET AVENUE, UTICA, NY 13502-5825
(315) 624-4663
(315) 624-4540
Mailing address
2521 SUNSET AVENUE, UTICA, NY 13502-5825
(315) 624-4660
(315) 624-4665
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01496088
—
NY
Enumeration date
08/20/2006
Last updated
09/02/2011
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