Provider Demographics
NPI:1124903992
Name:PRIVATE DUTY AIDES
Entity type:Organization
Organization Name:PRIVATE DUTY AIDES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:FEQUIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-395-0796
Mailing Address - Street 1:72 BANCROFT AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-1901
Mailing Address - Country:US
Mailing Address - Phone:203-395-0796
Mailing Address - Fax:
Practice Address - Street 1:832 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06704-3514
Practice Address - Country:US
Practice Address - Phone:203-395-0796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-09
Last Update Date:2025-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care