Healthcare Provider Details

I. General information

NPI: 1780359976
Provider Name (Legal Business Name): SAFER ADC YK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87 RIVERDALE AVE
YONKERS NY
10701-4609
US

IV. Provider business mailing address

42 RIVERGLEN DR
THIELLS NY
10984-1509
US

V. Phone/Fax

Practice location:
  • Phone: 718-650-2690
  • Fax:
Mailing address:
  • Phone: 516-477-5938
  • 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: GERSHON BLATTER
Title or Position: CEO
Credential:
Phone: 516-477-5938