Healthcare Provider Details

I. General information

NPI: 1649124538
Provider Name (Legal Business Name): JACKSON HEIGHTS SOCIAL ADULT DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3722 73RD ST
JACKSON HEIGHTS NY
11372-6272
US

IV. Provider business mailing address

3722 73RD ST
JACKSON HEIGHTS NY
11372-6272
US

V. Phone/Fax

Practice location:
  • Phone: 212-466-6377
  • Fax:
Mailing address:
  • Phone: 212-466-6377
  • 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: SIFA AMIN
Title or Position: PRESIDENT & CEO
Credential:
Phone: 646-961-6554