Healthcare Provider Details

I. General information

NPI: 1184971525
Provider Name (Legal Business Name): EAST RED ADULT DAY CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2012
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date: 10/30/2015
Reactivation Date: 01/26/2016

III. Provider practice location address

37 CATHERINE STREET GROUND FLOOR
NEW YORK NY
10038-1007
US

IV. Provider business mailing address

37 CATHERINE STREET GROUND FLOOR
NEW YORK NY
10038-1007
US

V. Phone/Fax

Practice location:
  • Phone: 212-608-1792
  • Fax: 877-280-2901
Mailing address:
  • Phone: 212-608-1792
  • Fax: 877-280-2901

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: CONNIE CHAN
Title or Position: ADMINISTRATOR
Credential:
Phone: 212-608-1792