Provider Demographics
NPI:1477802577
Name:GENESIS ADULT DAYCARE
Entity Type:Organization
Organization Name:GENESIS ADULT DAYCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOISHE
Authorized Official - Middle Name:J
Authorized Official - Last Name:OIRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-634-4013
Mailing Address - Street 1:13401 ROCKAWAY BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1450
Mailing Address - Country:US
Mailing Address - Phone:718-634-4013
Mailing Address - Fax:718-634-4059
Practice Address - Street 1:13401 ROCKAWAY BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BELLE HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11694-1450
Practice Address - Country:US
Practice Address - Phone:718-634-4013
Practice Address - Fax:718-634-4059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11111111111111111111OtherMANAGECARE INSURANCE