Provider Demographics
NPI:1407062409
Name:NEW LIFE ADULT MEDICAL DAY CARE CORP
Entity Type:Organization
Organization Name:NEW LIFE ADULT MEDICAL DAY CARE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ZHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALERGANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-265-0606
Mailing Address - Street 1:340 EVELYN ST
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2908
Mailing Address - Country:US
Mailing Address - Phone:201-265-0606
Mailing Address - Fax:201-265-0630
Practice Address - Street 1:340 EVELYN ST
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-2908
Practice Address - Country:US
Practice Address - Phone:201-265-0606
Practice Address - Fax:201-265-0630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ15W32J261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0160300OtherJACC
NJ0160300OtherCAP
NJ8630402Medicaid
NJ0160300OtherCAP