Provider Demographics
NPI:1851786941
Name:I & Y SENIOR CARE, INC.
Entity type:Organization
Organization Name:I & Y SENIOR CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEATA
Authorized Official - Middle Name:
Authorized Official - Last Name:REZAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-253-0077
Mailing Address - Street 1:1991 FLATBUSH AVENUE, 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3524
Mailing Address - Country:US
Mailing Address - Phone:718-253-0077
Mailing Address - Fax:347-253-0071
Practice Address - Street 1:1991 FLATBUSH AVENUE, 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3524
Practice Address - Country:US
Practice Address - Phone:718-253-0077
Practice Address - Fax:347-253-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1782L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04175095Medicaid