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General NPI Number Information
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NPI Number | 1063801991
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Entity Type | Organization
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Legal Business Name | ENIGMA ADULT DAY CARE CENTER
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 02/23/2015
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Provider Practice Location Address
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Address Line | 33-11A 74TH STREET
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City | JACKSON HGHTS
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State | NY
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Zip | 11372
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Country | US
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Telephone | 646-920-5244
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Fax |
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Provider Business Mailing Address
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Address Line | 33 -11A 74TH STREET
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City | JACKSON HGTS
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State | NY
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Zip | 11372
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Country | US
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Telephone | 646-920-5244
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Fax |
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Authorized Official
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Title or Position | RN
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Name | MS. DOROTHY H LOKKO
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Credential | REGISTERED NURSE
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Telephone | 646-920-5244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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