Healthcare Provider Details

I. General information

NPI: 1538099593
Provider Name (Legal Business Name): RV
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 SUNRISE HWY UNIT 2
ROCKVILLE CENTRE NY
11570-4711
US

IV. Provider business mailing address

180 SUNRISE HWY UNIT 2
ROCKVILLE CENTRE NY
11570-4711
US

V. Phone/Fax

Practice location:
  • Phone: 516-536-5765
  • 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: SUMYA NUR
Title or Position: ADMINISTRATOR
Credential:
Phone: 347-809-1363