Healthcare Provider Details

I. General information

NPI: 1083950893
Provider Name (Legal Business Name): TREMONT SOCIAL GARDEN,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2012
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

563 E TREMONT AVE 2ND FLOOR
BRONX NY
10457-4655
US

IV. Provider business mailing address

563 E TREMONT AVE 2ND FLOOR
BRONX NY
10457-4655
US

V. Phone/Fax

Practice location:
  • Phone: 845-423-7822
  • Fax:
Mailing address:
  • Phone: 845-423-7822
  • Fax: 917-792-8502

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: SLAVIK GORD
Title or Position: OWNER
Credential:
Phone: 845-423-7822