MEDICARE: VILLAGE CENTER FOR CARE

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	7002335N	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679556450
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VILLAGE CENTER FOR CARE

Provider Business Mailing Address
First Line	:	120 BROADWAY
Second Line	:	SUITE 2840
City	:	NEW YORK
State	:	NY
Zip	:	10271-0009
Country	:	US
Telephone Number	:	212-337-5710
Fax Number	:	212-337-5839

Provider Business Practice Location Address
First Line	:	121 W 20TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10011-3641
Country	:	US
Telephone Number	:	212-337-9221
Fax Number	:	212-633-6587

Authorized Official
Title or Position	:	CFO
Name	:	DEBRA TIRADO
Credential	:
Telephone Number	:	212-337-5710

Provider Enumeration Date	:	11/25/2005
Last Update Date	:	10/04/2019

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Directions to “VILLAGE CENTER FOR CARE ” Practice Location

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