Healthcare Provider Details

I. General information

NPI: 1255679403
Provider Name (Legal Business Name): HAPPY ISLAND SENIOR CENTER,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 GREELEY AVE
STATEN ISLAND NY
10306-5807
US

IV. Provider business mailing address

555 GREELEY AVE
STATEN ISLAND NY
10306-5807
US

V. Phone/Fax

Practice location:
  • Phone: 718-980-0240
  • Fax: 718-980-0242
Mailing address:
  • Phone: 718-980-0240
  • Fax: 718-980-0242

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: MR. YAKOV MOIN
Title or Position: PRESIDENT
Credential:
Phone: 718-980-0240