Healthcare Provider Details

I. General information

NPI: 1598214132
Provider Name (Legal Business Name): ADVANCED SENIOR CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22005 JAMAICA AVE GROUND FLOOR
QUEENS VILLAGE NY
11428-2140
US

IV. Provider business mailing address

22005 JAMAICA AVE GROUND FLOOR
QUEENS VILLAGE NY
11428-2140
US

V. Phone/Fax

Practice location:
  • Phone: 718-338-6300
  • Fax:
Mailing address:
  • Phone: 718-338-6300
  • 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: DR. LEONARD BLEICHER
Title or Position: PRESIDENT
Credential: MD
Phone: 718-338-6300