Provider Demographics
NPI:1447071618
Name:PHOENIX CARE LLC
Entity type:Organization
Organization Name:PHOENIX CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SERENE
Authorized Official - Middle Name:
Authorized Official - Last Name:FENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-489-1828
Mailing Address - Street 1:133-36/38 41ST RD CS8
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-2666
Mailing Address - Country:US
Mailing Address - Phone:718-489-1828
Mailing Address - Fax:
Practice Address - Street 1:14307 SANFORD AVE APT 1A
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2001
Practice Address - Country:US
Practice Address - Phone:718-888-9087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty