Healthcare Provider Details

I. General information

NPI: 1306102363
Provider Name (Legal Business Name): CHINATOWN SENIOR SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 07/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 LUDLOW ST 2ND FL.
NEW YORK NY
10002-3802
US

IV. Provider business mailing address

90 LUDLOW ST 2ND FL.
NEW YORK NY
10002-3802
US

V. Phone/Fax

Practice location:
  • Phone: 212-598-5878
  • Fax:
Mailing address:
  • Phone: 212-598-5878
  • 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: CASEY LAM
Title or Position: OFFICER
Credential:
Phone: 212-598-5878