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General NPI Number Information
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NPI Number | 1902248602
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Entity Type | Organization
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Legal Business Name | SU CASA ADULT DAY CARE
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 533 PORT RICHMOND AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10302-1720
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Country | US
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Telephone | 718-448-3898
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Fax | 718-442-3986
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Provider Business Mailing Address
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Address Line | 533 PORT RICHMOND AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10302-1720
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Country | US
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Telephone | 718-448-3898
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Fax | 718-442-3986
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Authorized Official
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Title or Position | MANAGER
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Name | NAQI A. SYED
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Credential |
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Telephone | 718-448-3898
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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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