Healthcare Provider Details

I. General information

NPI: 1568023620
Provider Name (Legal Business Name): EAGLES ADULT DAY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2019
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 MIDLAND AVE
STATEN ISLAND NY
10306-5104
US

IV. Provider business mailing address

25 ATHENA PL
STATEN ISLAND NY
10314-5501
US

V. Phone/Fax

Practice location:
  • Phone: 929-435-3268
  • Fax: 718-370-1642
Mailing address:
  • Phone: 917-605-1240
  • Fax: 718-370-1642

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: AURORA RRUSTJA
Title or Position: OWNER
Credential:
Phone: 917-605-1240