Healthcare Provider Details

I. General information

NPI: 1033950860
Provider Name (Legal Business Name): SILVER TOWN ADULT DAY CARE CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 06/05/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 HAVEMEYER AVENUE
BRONX NY
10462
US

IV. Provider business mailing address

147-28 NORTHERN BLVD
FLUSHING NY
11354
US

V. Phone/Fax

Practice location:
  • Phone: 929-734-5030
  • Fax: 929-734-5039
Mailing address:
  • Phone: 718-631-7979
  • Fax: 347-732-9114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SEUNGJA CHANG
Title or Position: PRESIDENT
Credential:
Phone: 718-631-7979