Provider Demographics
NPI:1124462254
Name:LUTHERAN CHHA
Entity type:Organization
Organization Name:LUTHERAN CHHA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESDIENT - FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-630-8298
Mailing Address - Street 1:5434 2ND AVE
Mailing Address - Street 2:LUTHERAN AUGUSTANA CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2606
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5434 2ND AVE
Practice Address - Street 2:LUTHERAN AUGUSTANA CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2606
Practice Address - Country:US
Practice Address - Phone:718-630-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY337452Medicare Oscar/Certification