Provider Demographics
NPI:1023532777
Name:GNY HOME CARE SERVICE LLC
Entity type:Organization
Organization Name:GNY HOME CARE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-690-1967
Mailing Address - Street 1:13229 BLOSSOM AVE # CF14
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4915
Mailing Address - Country:US
Mailing Address - Phone:718-690-1967
Mailing Address - Fax:347-542-3919
Practice Address - Street 1:13229 BLOSSOM AVE # CF14
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4915
Practice Address - Country:US
Practice Address - Phone:718-690-1967
Practice Address - Fax:347-542-3919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health