Provider Demographics
NPI:1285314773
Name:ASIA, CAROL (HHA)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:ASIA
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BETSY ROSS DR
Mailing Address - Street 2:
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-4003
Mailing Address - Country:US
Mailing Address - Phone:631-307-6533
Mailing Address - Fax:
Practice Address - Street 1:25 BETSY ROSS DR
Practice Address - Street 2:
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-4003
Practice Address - Country:US
Practice Address - Phone:631-587-1056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-20
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY128147374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide