Provider Demographics
NPI:1366552697
Name:EFCC ACQUISITION CORP
Entity type:Organization
Organization Name:EFCC ACQUISITION CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STERNBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-423-6689
Mailing Address - Street 1:115 BROADHOLLOW RD
Mailing Address - Street 2:SUITE 275
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4992
Mailing Address - Country:US
Mailing Address - Phone:631-423-6689
Mailing Address - Fax:631-427-5466
Practice Address - Street 1:1251 S CEDAR CREST BLVD
Practice Address - Street 2:STE 102B
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6205
Practice Address - Country:US
Practice Address - Phone:610-432-6766
Practice Address - Fax:610-432-6690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN048916L164W00000X
PARN535639163W00000X
PA013205251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007772400035Medicaid
PA1007772400035Medicaid