Organization
ISLAND HOME CARE AGENCY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN FECHTMANN (VICE PRESIDENT/ADMINISTRATOR)
(631) 289-6223
Entity
Organization
Contact information
Practice address
175 COMMERCE DR STE D, HAUPPAUGE, NY 11788-3920
(631) 289-6223
(631) 289-7473
Mailing address
175 COMMERCE DR STE D, HAUPPAUGE, NY 11788-3920
(631) 289-6223
(631) 289-7473
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
1578L001
NY
251J00000X
Nursing Care Agency
Primary
1578L001
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S065B
EBCBS
NY
Enumeration date
08/19/2010
Last updated
08/19/2010
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