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NPI Code Detail

MEDICARE: SILVER AGE OF SHEEPSHEAD BAY, INC.

MEDICARE: SILVER AGE OF SHEEPSHEAD BAY, 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
1261QA0600XAdult Day Care Clinic/Center

General Provider Information

NPI Number : 1962746867
Entity Type Code : Organization
Provider Name (Legal Business Name) : SILVER AGE OF SHEEPSHEAD BAY, INC.
Provider Business Mailing Address
First Line : 2915 E 5TH ST.
Second Line : 9E
City : BROOKLYN
State : NY
Zip : 11224
Country : US
Telephone Number : 347-325-3737
Fax Number :
Provider Business Practice Location Address
First Line : 2752 OCEAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-4706
Country : US
Telephone Number : 347-325-3737
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : RITA YAKHNIS
Credential :
Telephone Number : 347-325-3737
Provider Enumeration Date : 11/15/2012
Last Update Date : 11/15/2012

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Directions to “SILVER AGE OF SHEEPSHEAD BAY, INC. ” Practice Location

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