Provider Demographics
NPI:1245935873
Name:NYSADC INCORPORATED
Entity type:Organization
Organization Name:NYSADC INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NADARA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-321-3089
Mailing Address - Street 1:25116 HILLSIDE AVE # 16
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-2150
Mailing Address - Country:US
Mailing Address - Phone:646-321-3089
Mailing Address - Fax:917-725-9807
Practice Address - Street 1:25116 HILLSIDE AVE # 16
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-2150
Practice Address - Country:US
Practice Address - Phone:646-321-3089
Practice Address - Fax:917-725-9807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home