Fadmo Health and Home Care Agency Inc

Primary specialty

Home Infusion AgencyTaxonomy code 251F00000X

Legal business name

FADMO HEALTH AND HOME CARE AGENCY INC

Practice address

194 Targee St
Staten Island, NY 10304-1926

Phone

(718) 390-0561

Fax

(718) 390-5166

NPI assigned

Dec 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Abby Agboola, CNM

Title

Ceo

Phone

(718) 390-0561

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• FADMO HEALTH AND ALLIED SCHOOL Former legal business name

Tax ID family

Fadmo Health and Allied School2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fadmo HHC

  • Home Health Agency
  • Staten Island, NY
  • NPI 1760774400
  NPD tax ID

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Abiola A Agboola, RN CNM

  • Clinical Pathology Physician
  • Staten Island, NY
  • NPI 1790084507
  NPD (past)
• Bridgette Cooper, RN

  • Registered Nurse
  • Staten Island, NY
  • NPI 1144568155
  NPD (past)
• Lucy Geller, RN

  • Community Health Registered Nurse
  • Staten Island, NY
  • NPI 1326337791
  NPD (past)
• Tola Simeon, LMSW

  • Social Worker
  • Staten Island, NY
  • NPI 1467731810
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614902400000",
    "number": "1073679205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 TARGEE ST",
            "address_2": "ABBY AGBOOLA",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041926",
            "telephone_number": "718-390-0561",
            "fax_number": "718-390-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 TARGEE ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041926",
            "telephone_number": "718-390-0561",
            "fax_number": "718-390-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FADMO HEALTH AND HOME CARE AGENCY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-30",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "AGBOOLA",
        "authorized_official_first_name": "ABBY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "718-390-0561",
        "authorized_official_credential": "CNM"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "403674-1",
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NY",
            "license": "403674-1",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NY",
            "license": "360383-1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1343L001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA WAIVER",
            "identifier": "1343L001",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FADMO HEALTH AND ALLIED SCHOOL",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "FADMO HEALTH AND ALLIED SCHOOL",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jude Raphael Villaluz Facura, LPN
• Mojeoyinola Esther Fadairo
• Mosunda Fadairo
• Elizabeth Fadale, LMHC
• Stefanie A Fadel, P.A.
• Fadmo HHC
• Mark David Fagala, MD
• Angela Fagen
• Maureen Fagen, P.T.
• Jacqueline Fagoni, NP-C

• Home Infusion Agency in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Home Infusion Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.