Extendacare Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

9589L001 Issued in NY

Legal business name

EXTENDACARE INC.

Doing business as

Medistaf Health & Research

Practice address

646 Main St
Port Jefferson, NY 11777-2235

Phone

(631) 473-1317

Fax

(631) 473-1337

NPI assigned

Apr 26, 2007

Last updated

Oct 6, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bruce A Uveges

Title

Administrator

Phone

(631) 473-1317

Specialties & licenses 3

Addresses

Other names 1

• Medistaf Health & Research Doing business as

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1669692448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772235",
            "telephone_number": "631-473-1317",
            "fax_number": "631-473-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "646 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772235",
            "telephone_number": "631-473-1317",
            "fax_number": "631-473-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTENDACARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "UVEGES",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "631-473-1317",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "9589L001",
            "primary": true
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "NY",
            "license": "9589L001",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NY",
            "license": "9589L001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medistaf Health & Research",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hilda Lucrecia Enriquez, D.O.
• Erin Equinozzi
• Kristin Ericson, LCSW
• Evolution Home Physical Therapy, P.C.
• Evolve Healthcare Partners
• Ralph F Fabiani, NP
• George G Fairey, MD
• Family Medical Wellness PC
• Kathleen Fanelli
• Armon Farhani, DO

• Home Health Agency in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Home Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; 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.