Provider Demographics
NPI:1528286150
Name:MJ-MC HOME HEALTH CARE AGENCY,INC
Entity type:Organization
Organization Name:MJ-MC HOME HEALTH CARE AGENCY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:
Authorized Official - Last Name:PYATNYCHUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-513-1728
Mailing Address - Street 1:1810 JEROME AVE
Mailing Address - Street 2:1ST FL.
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3621
Mailing Address - Country:US
Mailing Address - Phone:718-513-1728
Mailing Address - Fax:718-513-1732
Practice Address - Street 1:1810 JEROME AVE.
Practice Address - Street 2:1ST . FL.
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3621
Practice Address - Country:US
Practice Address - Phone:718-513-1728
Practice Address - Fax:718-513-1732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1179L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health