Nishan Akwalia

Individual provider Active NPI In Home Supportive Care Agency · Levittown, NY

NPI 1043764020 · NPPES record last updated Aug 8, 2016

Key facts

NPI
1043764020
Entity type
Individual (NPI type 1)
Primary specialty
In Home Supportive Care Agency 253Z00000X
License
040319 (NY)
Practice address
257 N Newbridge Rd Apt 2C
Levittown, NY 11756-1596
Phone
(704) 622-5274
NPI assigned
Aug 8, 2016
Sex
Male
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
040319NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bravo Occupational Therapy PC Past
since Jan 1, 2017
Accepting new patients
Genesis Medical Health PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 040319 NY Yes

Addresses

Primary practice location

257 N Newbridge Rd Apt 2C
Levittown, NY 11756-1596

Mailing address

257 N Newbridge Rd Apt 2C
Levittown, NY 11756-1596

Other providers in Levittown, NY

All providers in Levittown, NY · In Home Supportive Care Agency in New York

Sources for this page

Verify at the official NPI Registry.