Provider Demographics
NPI:1023303047
Name:MEALS ON WHEELS OF SI, INC.
Entity type:Organization
Organization Name:MEALS ON WHEELS OF SI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:TORNELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-727-4435
Mailing Address - Street 1:304 PORT RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302-1705
Mailing Address - Country:US
Mailing Address - Phone:718-727-4435
Mailing Address - Fax:718-727-2157
Practice Address - Street 1:304 PORT RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302-1705
Practice Address - Country:US
Practice Address - Phone:718-727-4435
Practice Address - Fax:718-727-2157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03153037Medicaid