Basic Information
Provider Information
NPI: 1124155825
EntityType: 2
ReplacementNPI:  
OrganizationName: PIONEER HOMECARE INC.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2052 TILLOTSON AVE
Address2: SUITE 101
City: BRONX
State: NY
PostalCode: 104751560
CountryCode: US
TelephoneNumber: 7186712100
FaxNumber: 7186711269
Practice Location
Address1: 2052 TILLOTSON AVE
Address2: SUITE 101
City: BRONX
State: NY
PostalCode: 104751560
CountryCode: US
TelephoneNumber: 7186712100
FaxNumber: 7186711269
Other Information
ProviderEnumerationDate: 02/28/2007
LastUpdateDate: 02/13/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: EMENIKE
AuthorizedOfficialFirstName: PATIENCE
AuthorizedOfficialMiddleName: ESE
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 7186712100
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: LPN
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X9729L001NYY AgenciesHome Health 

ID Information
IDTypeStateIssuerDescription
0175302005NY MEDICAID


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