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NPI Code Detail

MEDICARE: ROCKAWAY ADULT SOCIAL CENTER

MEDICARE: ROCKAWAY ADULT SOCIAL CENTER
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 : 1992121263
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROCKAWAY ADULT SOCIAL CENTER
Provider Business Mailing Address
First Line : 1858 CORNAGA AVE
Second Line :
City : FAR ROCKAWAY
State : NY
Zip : 11691-4304
Country : US
Telephone Number : 347-926-4134
Fax Number :
Provider Business Practice Location Address
First Line : 1858 CORNAGA AVE
Second Line :
City : FAR ROCKAWAY
State : NY
Zip : 11691-4304
Country : US
Telephone Number : 347-926-4134
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MS. RUTH JACOBOVITCH
Credential :
Telephone Number : 347-926-4134
Provider Enumeration Date : 03/11/2014
Last Update Date : 08/19/2015

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Directions to “ROCKAWAY ADULT SOCIAL CENTER ” Practice Location

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