NPIMap

Organization Active NPI

Shorefront Jewish Geriatric Dba MJGC Homecare

  • Home Health Agency
  • Brooklyn, NY
National Provider Identifier
1396944625
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
5902610 Issued in NY
Legal business name
SHOREFRONT JEWISH GERIATRIC DBA MJGC HOMECARE
Practice address
6323 7TH Ave
Brooklyn, NY 11220-4742
Phone
(718) 491-7221
Fax
(718) 759-4555
NPI assigned
Jul 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

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

Authorized official

Name
Alexander Balko
Title
Sr. VP Chief Financial Officer
Phone
(718) 491-7221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 5902610 NY Primary

Addresses

Primary practice location

6323 7TH Ave
Brooklyn, NY 11220-4742

Mailing address

6323 7TH Ave
Brooklyn, NY 11220-4742
Phone (718) 491-7221

Other identifiers 1

IdentifierTypeStateIssuer
01049729MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
MJG Nursing Home Company Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184630400000",
    "number": "1396944625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6323 7TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204742",
            "telephone_number": "718-491-7221",
            "fax_number": "718-759-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6323 7TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112204742",
            "telephone_number": "718-491-7221",
            "fax_number": "718-759-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOREFRONT JEWISH GERIATRIC DBA MJGC HOMECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A",
        "authorized_official_last_name": "BALKO",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "SR. VP CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "718-491-7221"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "5902610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01049729",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.