Provider Demographics
NPI:1104902949
Name:DOMINICAN SISTERS FAMILY HEALTH SERVICE INC
Entity type:Organization
Organization Name:DOMINICAN SISTERS FAMILY HEALTH SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MS, DPT, LNHA, F
Authorized Official - Phone:914-941-1710
Mailing Address - Street 1:299 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-2327
Mailing Address - Country:US
Mailing Address - Phone:914-941-1710
Mailing Address - Fax:914-941-0518
Practice Address - Street 1:299 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-2327
Practice Address - Country:US
Practice Address - Phone:914-941-1710
Practice Address - Fax:914-941-0518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5905901L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01136130Medicaid