Provider Demographics
NPI:1285162685
Name:CAPTOR USA, INC.
Entity type:Organization
Organization Name:CAPTOR USA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:IFTEKHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MSS IN ECONOMICS
Authorized Official - Phone:201-456-3103
Mailing Address - Street 1:3715 73RD ST STE 205
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6262
Mailing Address - Country:US
Mailing Address - Phone:201-456-3103
Mailing Address - Fax:
Practice Address - Street 1:3715 73RD ST STE 205
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6262
Practice Address - Country:US
Practice Address - Phone:201-456-3103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4894444253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care