NPIMap

Organization Active NPI

Island Home Care Agency, Inc.

  • Home Infusion Agency
  • Hauppauge, NY
National Provider Identifier
1609186436
Registry record updated Oct 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
License
1578L001 Issued in NY
Legal business name
ISLAND HOME CARE AGENCY, INC.
Practice address
175 Commerce Drive
Ste D
Hauppauge, NY 11788-3920
Phone
(631) 289-6223
Fax
(631) 289-7473
NPI assigned
Oct 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2010

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

Authorized official

Name
Susan Fechtmann
Title
Vice President/Administrator
Phone
(631) 289-6223

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Infusion Agency 251F00000X 1578L001 NY Primary

Addresses

Primary practice location

175 Commerce Drive
Ste D
Hauppauge, NY 11788-3920

Mailing address

175 Commerce Drive
Ste D
Hauppauge, NY 11788-3920
Phone (631) 289-6223

Other identifiers 1

IdentifierTypeStateIssuer
00884579MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Island Home Care Agency Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

175 Commerce Dr
Ste D
Hauppauge, NY 11788
Phone (516) 208-8749

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287014400000",
    "number": "1609186436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 COMMERCE DRIVE",
            "address_2": "STE D",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883920",
            "telephone_number": "631-289-6223",
            "fax_number": "631-289-7473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 COMMERCE DRIVE",
            "address_2": "STE D",
            "city": "HAUPPAUGE",
            "state": "NY",
            "postal_code": "117883920",
            "telephone_number": "631-289-6223",
            "fax_number": "631-289-7473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND HOME CARE AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-14",
        "last_updated": "2010-10-14",
        "status": "A",
        "authorized_official_last_name": "FECHTMANN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "VICE PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "631-289-6223"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "NY",
            "license": "1578L001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00884579",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hauppauge, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; 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.