Healthcare Provider Details

I. General information

NPI: 1144704685
Provider Name (Legal Business Name): BUFFALO SOCIAL ADULT DAY CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2018
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 E DELAVAN AVE
BUFFALO NY
14215-3104
US

IV. Provider business mailing address

16001 84TH AVE
JAMAICA NY
11432-1713
US

V. Phone/Fax

Practice location:
  • Phone: 646-591-6782
  • Fax: 347-694-8854
Mailing address:
  • Phone: 646-591-6782
  • Fax: 347-694-8854

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: MR. MAZFUZUL HAQUE
Title or Position: PRESIDENT
Credential:
Phone: 646-591-6782