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General NPI Number Information
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NPI Number | 1285309849
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Entity Type | Organization
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Legal Business Name | AL ANDALUS COMMUNITY SERVICES OF NEW YORK
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Dates
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Enumeration Date | 08/14/2021
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 3075 RICHMOND TER
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City | STATEN ISLAND
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State | NY
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Zip | 10303-1303
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Country | US
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Telephone | 646-339-1894
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Fax |
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Provider Business Mailing Address
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Address Line | 19 MELBA ST
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City | STATEN ISLAND
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State | NY
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Zip | 10314-5334
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Country | US
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Telephone | 646-339-1894
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | AHMAD HUSSEIN
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Credential |
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Telephone | 646-339-1894
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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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