Healthcare Provider Details

I. General information

NPI: 1083978407
Provider Name (Legal Business Name): LY YONKERS ADULT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 04/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 NEPPERHAN AVE
YONKERS NY
10703-2857
US

IV. Provider business mailing address

525 NEPPERHAN AVE
YONKERS NY
10703-2857
US

V. Phone/Fax

Practice location:
  • Phone: 718-801-7833
  • Fax:
Mailing address:
  • Phone: 718-801-7833
  • 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: MS. XIAO PING ZHANG
Title or Position: DIRECTOR
Credential: R.N.
Phone: 718-801-7833