Provider Demographics
NPI:1194970392
Name:NEW AGE HOME INFUSION SERVICES INC
Entity type:Organization
Organization Name:NEW AGE HOME INFUSION SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:718-687-7355
Mailing Address - Street 1:47 CAROL COURT
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309
Mailing Address - Country:US
Mailing Address - Phone:718-687-7355
Mailing Address - Fax:
Practice Address - Street 1:47 CAROL CT
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-3536
Practice Address - Country:US
Practice Address - Phone:718-687-7355
Practice Address - Fax:718-701-5970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9739L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health