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General NPI Number Information
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NPI Number | 1568023620
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Entity Type | Organization
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Legal Business Name | EAGLES ADULT DAY INC
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Dates
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Enumeration Date | 06/27/2019
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 460 MIDLAND AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10306-5104
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Country | US
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Telephone | 929-435-3268
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Fax | 718-370-1642
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Provider Business Mailing Address
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Address Line | 25 ATHENA PL
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City | STATEN ISLAND
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State | NY
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Zip | 10314-5501
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Country | US
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Telephone | 917-605-1240
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Fax | 718-370-1642
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Authorized Official
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Title or Position | OWNER
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Name | AURORA RRUSTJA
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Credential |
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Telephone | 917-605-1240
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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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