MEDICARE: EZDAY ADULT DAYCARE, INC

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	251S00000X	Community/Behavioral Health

General Provider Information

NPI Number	:	1730432634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EZDAY ADULT DAYCARE, INC

Provider Business Mailing Address
First Line	:	620 east 102nd street
Second Line	:
City	:	Brooklyn
State	:	NY
Zip	:	11236
Country	:	US
Telephone Number	:	718-257-2700
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 EAST 102ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236
Country	:	US
Telephone Number	:	718-257-2700
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. STEVE VASCO
Credential	:
Telephone Number	:	347-277-4835

Provider Enumeration Date	:	10/17/2012
Last Update Date	:	10/17/2012

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