Provider Demographics
NPI:1851940597
Name:SHANTI NIKETAN INC
Entity Type:Organization
Organization Name:SHANTI NIKETAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHANMUGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SRIDHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-740-9400
Mailing Address - Street 1:76-18 266TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040
Mailing Address - Country:US
Mailing Address - Phone:718-740-9400
Mailing Address - Fax:
Practice Address - Street 1:236-03 BRADDOCK
Practice Address - Street 2:SHANTINIKETAN - A SENIOR DAY CARE CENTER
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426
Practice Address - Country:US
Practice Address - Phone:718-781-0885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care