Healthcare Provider Details

I. General information

NPI: 1083936017
Provider Name (Legal Business Name): QUEENS BOROUGH DAY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2010
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14152 33RD AVE
FLUSHING NY
11354-3229
US

IV. Provider business mailing address

14152 33RD AVE
FLUSHING NY
11354-3229
US

V. Phone/Fax

Practice location:
  • Phone: 718-353-1740
  • Fax: 718-353-4902
Mailing address:
  • Phone: 718-353-1740
  • Fax: 718-353-4902

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: VIKTORIYA STOVAL
Title or Position: ADMINISTRATOR
Credential:
Phone: 718-353-1740