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General NPI Number Information
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NPI Number | 1770039349
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Entity Type | Organization
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Legal Business Name | ASIAN ADULT DAY CARE CENTER
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4120 QUEENS BOULEVARD
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City | SUNNYSIDE
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State | NY
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Zip | 11104
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Country | US
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Telephone | 718-786-8396
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Fax |
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Provider Business Mailing Address
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Address Line | 4120 QUEENS BLVD
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City | SUNNYSIDE
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State | NY
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Zip | 11104-2802
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | PRABIR MITRA
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Credential |
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Telephone | 718-786-8396
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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 | NY
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