MEDICARE: BENSONHURST SOCIAL DAYCARE 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	:	1801677174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENSONHURST SOCIAL DAYCARE LLC

Provider Business Mailing Address
First Line	:	7124 18TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-5203
Country	:	US
Telephone Number	:	646-863-5919
Fax Number	:

Provider Business Practice Location Address
First Line	:	7124 18TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11204-5203
Country	:	US
Telephone Number	:	646-863-5919
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	HENG HAN PAN
Credential	:
Telephone Number	:	929-214-2185

Provider Enumeration Date	:	10/11/2023
Last Update Date	:	11/12/2025

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