Healthcare Provider Details

I. General information

NPI: 1841065869
Provider Name (Legal Business Name): BOWERY SENIOR CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 BOWERY ST. 2FL
NEW YORK NY
10002-6078
US

IV. Provider business mailing address

77 BOWERY ST. 2FL
NEW YORK NY
10002-6078
US

V. Phone/Fax

Practice location:
  • Phone: 917-702-9322
  • 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: JO PING LEE
Title or Position: OWNER
Credential:
Phone: 917-702-9332