Healthcare Provider Details

I. General information

NPI: 1528280823
Provider Name (Legal Business Name): FOREVER YOUNG MEDICAL DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 WORLDS FAIR DRIVE
SOMERSET NJ
08873
US

IV. Provider business mailing address

18 WORLDS FAIR DRIVE
SOMERSET NJ
08873
US

V. Phone/Fax

Practice location:
  • Phone: 732-271-8010
  • Fax: 732-271-8116
Mailing address:
  • Phone: 732-271-8010
  • Fax: 732-271-8116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number808310
License Number StateNJ

VIII. Authorized Official

Name: MRS. MARIYA TOLCHEVA
Title or Position: OWNER
Credential:
Phone: 732-271-8010