Healthcare Provider Details

I. General information

NPI: 1316301195
Provider Name (Legal Business Name): ROYAL ADULT DAYCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2016
Last Update Date: 04/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9717 64TH RD GROUND FLOOR
REGO PARK NY
11374-2261
US

IV. Provider business mailing address

9717 64TH RD GROUND FLOOR
REGO PARK NY
11374-2261
US

V. Phone/Fax

Practice location:
  • Phone: 917-444-2923
  • Fax: 718-713-0008
Mailing address:
  • Phone: 917-444-2923
  • Fax: 718-713-0008

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: ANAT HAIMOFF
Title or Position: OWNER
Credential:
Phone: 917-444-2923