Healthcare Provider Details

I. General information

NPI: 1023740115
Provider Name (Legal Business Name): IMPRESSIVE DAY CALE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3722 73RD ST STE A1
JACKSON HEIGHTS NY
11372-6273
US

IV. Provider business mailing address

3722 73RD ST STE A1
JACKSON HEIGHTS NY
11372-6273
US

V. Phone/Fax

Practice location:
  • Phone: 718-734-5600
  • Fax:
Mailing address:
  • Phone: 718-734-5600
  • Fax:

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. SHAHRIAR ARIF
Title or Position: CEO
Credential:
Phone: 718-734-5600