Provider Demographics
NPI:1609042175
Name:DELS COMPREHENSIVE HEALTH CARE REGISTRY AGENCY,INC
Entity type:Organization
Organization Name:DELS COMPREHENSIVE HEALTH CARE REGISTRY AGENCY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IKA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:718-539-8044
Mailing Address - Street 1:4566 162ND ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3158
Mailing Address - Country:US
Mailing Address - Phone:718-539-8044
Mailing Address - Fax:718-539-8045
Practice Address - Street 1:4566 162ND ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-3158
Practice Address - Country:US
Practice Address - Phone:718-539-8044
Practice Address - Fax:718-539-8045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9228L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health