Provider Demographics
NPI:1962601963
Name:ASTORIA HEALTHCARE, INC.
Entity type:Organization
Organization Name:ASTORIA HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-369-1794
Mailing Address - Street 1:6164 ALDAMA ST
Mailing Address - Street 2:#2
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-2646
Mailing Address - Country:US
Mailing Address - Phone:323-369-1794
Mailing Address - Fax:
Practice Address - Street 1:126 S JACKSON ST
Practice Address - Street 2:SUITE 301B
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-4922
Practice Address - Country:US
Practice Address - Phone:323-369-1794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGMedicare ID - Type UnspecifiedHOME HEALTH AGENCY