Healthcare Provider Details

I. General information

NPI: 1013324441
Provider Name (Legal Business Name): NEW YORK BRIDGE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 07/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

944 JERUSALEM AVE
UNIONDALE NY
11553-3003
US

IV. Provider business mailing address

944 JERUSALEM AVE
UNIONDALE NY
11553-3003
US

V. Phone/Fax

Practice location:
  • Phone: 516-826-1840
  • Fax: 516-826-1839
Mailing address:
  • Phone: 516-826-1840
  • Fax: 516-826-1839

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: ANDRE TAYLOR
Title or Position: PRESIDENT
Credential: MD
Phone: 516-826-1840