Provider Demographics
NPI:1831584796
Name:SHALOM SADC, INC.
Entity type:Organization
Organization Name:SHALOM SADC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GEISINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-603-9770
Mailing Address - Street 1:400 E SHORE RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024-2140
Mailing Address - Country:US
Mailing Address - Phone:516-603-9770
Mailing Address - Fax:516-482-2530
Practice Address - Street 1:400 E SHORE RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11024-2140
Practice Address - Country:US
Practice Address - Phone:516-603-9770
Practice Address - Fax:516-482-2530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care