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General NPI Number Information
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NPI Number | 1639519721
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Entity Type | Organization
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Legal Business Name | PINE CARE LLC
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Dates
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Enumeration Date | 07/03/2013
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 3710 149TH PL #1A
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City | FLUSHING
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State | NY
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Zip | 11354
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Country | US
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Telephone | 718-358-3355
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Fax | 347-732-9973
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Provider Business Mailing Address
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Address Line | 3710 149TH PL #1A
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City | FLUSHING
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State | NY
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Zip | 11354
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Country | US
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Telephone | 718-358-3355
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Fax | 347-732-9973
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Authorized Official
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Title or Position | PRESIDENT
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Name | YOONSHIN KANG
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Credential |
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Telephone | 516-974-6498
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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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