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NPI Code Detail

MEDICARE: MORNINGSIDE ACQUISITION I, LLC

MEDICARE: MORNINGSIDE ACQUISITION I, 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
1261QA0600XAdult Day Care Clinic/CenterNY

General Provider Information

NPI Number : 1992104657
Entity Type Code : Organization
Provider Name (Legal Business Name) : MORNINGSIDE ACQUISITION I, LLC
Provider Business Mailing Address
First Line : 1000 PELHAM PKWY S
Second Line :
City : BRONX
State : NY
Zip : 10461-1003
Country : US
Telephone Number : 718-409-8200
Fax Number :
Provider Business Practice Location Address
First Line : 1000 PELHAM PKWY S
Second Line :
City : BRONX
State : NY
Zip : 10461-1003
Country : US
Telephone Number : 718-409-8200
Fax Number :
Authorized Official
Title or Position : MANAGER / MEMBER
Name : PASQUALE DEBENEDICTIS
Credential :
Telephone Number : 516-422-7818
Provider Enumeration Date : 08/19/2014
Last Update Date : 08/19/2014

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Directions to “MORNINGSIDE ACQUISITION I, LLC ” Practice Location

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