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General NPI Number Information
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NPI Number | 1528280823
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Entity Type | Organization
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Legal Business Name | FOREVER YOUNG MEDICAL DAY CARE
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 07/01/2020
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Provider Practice Location Address
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Address Line | 18 WORLDS FAIR DRIVE
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City | SOMERSET
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State | NJ
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Zip | 08873
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Country | US
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Telephone | 732-271-8010
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Fax | 732-271-8116
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Provider Business Mailing Address
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Address Line | 18 WORLDS FAIR DRIVE
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City | SOMERSET
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State | NJ
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Zip | 08873
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Country | US
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Telephone | 732-271-8010
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Fax | 732-271-8116
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARIYA TOLCHEVA
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Credential |
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Telephone | 732-271-8010
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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 | 808310
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License Number State | NJ
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