Healthcare Provider Details

I. General information

NPI: 1154023117
Provider Name (Legal Business Name): CORONA SOCIAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 03/21/2023
Certification Date: 03/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 JUNCTION BLVD
CORONA NY
11368-1743
US

IV. Provider business mailing address

3530 JUNCTION BLVD
CORONA NY
11368-1743
US

V. Phone/Fax

Practice location:
  • Phone: 718-406-9103
  • Fax: 718-406-9165
Mailing address:
  • Phone: 718-406-9103
  • Fax: 718-406-9165

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: JOYCE LIU
Title or Position: DIRECTOR
Credential:
Phone: 516-851-7408