Healthcare Provider Details

I. General information

NPI: 1083152342
Provider Name (Legal Business Name): DESHI SENIOR CENTERLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2017
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8310 ROCKAWAY BLVD
OZONE PARK NY
11416
US

IV. Provider business mailing address

8310 ROCKAWAY BLVD
OZONE PARK NY
11416
US

V. Phone/Fax

Practice location:
  • Phone: 718-296-0077
  • Fax: 718-266-7100
Mailing address:
  • Phone: 718-296-0077
  • 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: MRS. ZHANNA GRIGORYAN
Title or Position: OWNER
Credential:
Phone: 917-697-1171