Healthcare Provider Details

I. General information

NPI: 1770995433
Provider Name (Legal Business Name): WOODHAVEN ADULT DAYCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 05/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 JAMAICA AVE
WOODHAVEN NY
11421-2233
US

IV. Provider business mailing address

9601 JAMAICA AVE
WOODHAVEN NY
11421-2233
US

V. Phone/Fax

Practice location:
  • Phone: 917-302-8100
  • 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: QIAN J ZHENG
Title or Position: ADMINISTRATOR
Credential:
Phone: 917-302-8100