Healthcare Provider Details

I. General information

NPI: 1710666557
Provider Name (Legal Business Name): TOPA GARDEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 07/17/2023
Certification Date: 07/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 E 125 STREET 3RD FLOOR
NEW YORK NY
10035-1688
US

IV. Provider business mailing address

51 E 125 STREET 3RD FLOOR
NEW YORK NY
10035-1688
US

V. Phone/Fax

Practice location:
  • Phone: 917-916-9468
  • Fax:
Mailing address:
  • Phone: 917-916-9468
  • 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: SERGEY YERMAKOV
Title or Position: PRESIDENT
Credential:
Phone: 917-916-9468