MEDICARE: RISING STARLINGS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1659200517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RISING STARLINGS LLC

Provider Business Mailing Address
First Line	:	241 FAIRBANKS AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-4103
Country	:	US
Telephone Number	:	917-392-3352
Fax Number	:

Provider Business Practice Location Address
First Line	:	241 FAIRBANKS AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10306-4103
Country	:	US
Telephone Number	:	917-392-3352
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. YELENA COSSACK
Credential	:
Telephone Number	:	917-392-3352

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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Directions to “RISING STARLINGS LLC ” Practice Location

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