Healthcare Provider Details
I. General information
NPI: 1588042824
Provider Name (Legal Business Name): DYKER SENIOR CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/06/2015
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6713 11TH AVE
BROOKLYN NY
11219-5904
US
IV. Provider business mailing address
6713 11TH AVE
BROOKLYN NY
11219-6381
US
V. Phone/Fax
- Phone: 718-331-8388
- Fax: 718-331-8338
- Phone: 718-331-8388
- Fax: 718-331-8338
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251T00000X |
| Taxonomy | PACE Provider Organization |
| License Number | 4570739 |
| License Number State | NY |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WEI
GUO
Title or Position: OWNER
Credential:
Phone: 917-288-9878