MEDICARE: BAINBRIDGE ADULT DAY CARE CENTER II, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1215283452
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAINBRIDGE ADULT DAY CARE CENTER II, LLC

Provider Business Mailing Address
First Line	:	1804 63RD ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-2932
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3518 BAINBRIDGE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-1402
Country	:	US
Telephone Number	:	718-655-1700
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	MR. BENJAMIN S FELDMAN
Credential	:
Telephone Number	:	718-655-1700

Provider Enumeration Date	:	07/25/2012
Last Update Date	:	07/25/2012

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