Healthcare Provider Details

I. General information

NPI: 1154282531
Provider Name (Legal Business Name): PRESTIGE ADULT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2504 BROADWAY
NEW YORK NY
10025-6949
US

IV. Provider business mailing address

312 LONG BEACH RD
ISLAND PARK NY
11558-1510
US

V. Phone/Fax

Practice location:
  • Phone: 631-923-2262
  • Fax:
Mailing address:
  • Phone:
  • 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: ORLETTE MILLER
Title or Position: OWNER/CEO
Credential:
Phone: 631-923-2262