Healthcare Provider Details

I. General information

NPI: 1518690080
Provider Name (Legal Business Name): SUFI SOCIAL ADULT DAY CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2022
Last Update Date: 07/02/2022
Certification Date: 07/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HELEN KELLER WAY
HEMPSTEAD NY
11550-3980
US

IV. Provider business mailing address

1 HELEN KELLER WAY
HEMPSTEAD NY
11550-3980
US

V. Phone/Fax

Practice location:
  • Phone: 631-533-7160
  • Fax: 631-533-7161
Mailing address:
  • Phone: 631-533-7160
  • Fax: 631-533-7161

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: MRS. JENNIFER BADEN AHMED
Title or Position: PRACTICE MANAGER
Credential: MD
Phone: 347-925-8914