Healthcare Provider Details

I. General information

NPI: 1023747417
Provider Name (Legal Business Name): E JIA ADULT DAYCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

876 60TH ST FL 1
BROOKLYN NY
11220-4293
US

IV. Provider business mailing address

876 60TH ST FL 1
BROOKLYN NY
11220-4293
US

V. Phone/Fax

Practice location:
  • Phone: 646-760-9339
  • Fax:
Mailing address:
  • Phone: 646-681-1180
  • Fax: 929-322-9599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YAQI WANG
Title or Position: PRESIDENT
Credential:
Phone: 646-760-9339