Provider Demographics
NPI:1891847919
Name:ADULT MEDICAL DAY CARE CORP. OF BAYONNE
Entity Type:Organization
Organization Name:ADULT MEDICAL DAY CARE CORP. OF BAYONNE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:ARSHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-660-4190
Mailing Address - Street 1:801 803 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002
Mailing Address - Country:US
Mailing Address - Phone:201-243-0035
Mailing Address - Fax:201-243-0036
Practice Address - Street 1:801 803 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002
Practice Address - Country:US
Practice Address - Phone:201-243-0035
Practice Address - Fax:201-243-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ408212261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0028312Medicaid