Healthcare Provider Details

I. General information

NPI: 1245935873
Provider Name (Legal Business Name): NYSADC INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25116 HILLSIDE AVE # 16
BELLEROSE NY
11426-2150
US

IV. Provider business mailing address

25116 HILLSIDE AVE # 16
BELLEROSE NY
11426-2150
US

V. Phone/Fax

Practice location:
  • Phone: 646-321-3089
  • Fax: 917-725-9807
Mailing address:
  • Phone: 646-321-3089
  • Fax: 917-725-9807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: NADARA RAHMAN
Title or Position: CEO
Credential:
Phone: 646-321-3089