Healthcare Provider Details

I. General information

NPI: 1760721229
Provider Name (Legal Business Name): SECOND FAMILY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2013
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 E 121ST ST
NEW YORK NY
10035-3018
US

IV. Provider business mailing address

203 EAST 121 ST
NEW YORK NY
10035
US

V. Phone/Fax

Practice location:
  • Phone: 718-916-7949
  • Fax: 212-813-4501
Mailing address:
  • Phone: 212-831-4500
  • Fax: 212-831-4501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number335720156
License Number StateNY

VIII. Authorized Official

Name: PETER MESHREKY
Title or Position: OWNER
Credential:
Phone: 212-831-4500