Provider Demographics
NPI:1316283898
Name:STARLIGHT MEDICAL HOMECARE OF NY P.C.
Entity type:Organization
Organization Name:STARLIGHT MEDICAL HOMECARE OF NY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-271-9151
Mailing Address - Street 1:95 BROADHOLLOW RD
Mailing Address - Street 2:STE. 101
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2506
Mailing Address - Country:US
Mailing Address - Phone:631-271-9151
Mailing Address - Fax:
Practice Address - Street 1:95 BROADHOLLOW RD
Practice Address - Street 2:STE. 101
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-2506
Practice Address - Country:US
Practice Address - Phone:631-271-9151
Practice Address - Fax:631-271-9155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219650207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY219650OtherLICENSE