Provider Demographics
NPI:1922489004
Name:AP SENIOR CARE CENTER
Entity Type:Organization
Organization Name:AP SENIOR CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANMUGAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SRIDHAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-979-2188
Mailing Address - Street 1:6217 99TH ST
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1441
Mailing Address - Country:US
Mailing Address - Phone:607-379-2188
Mailing Address - Fax:
Practice Address - Street 1:6217 99TH ST
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1441
Practice Address - Country:US
Practice Address - Phone:607-379-2188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-14
Last Update Date:2015-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization