Provider Demographics
NPI:1841541323
Name:FIRST STATEN ISLAND SENIOR DAYCARE CENTER INC
Entity type:Organization
Organization Name:FIRST STATEN ISLAND SENIOR DAYCARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-889-0978
Mailing Address - Street 1:473 CLOVE ROAD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2317
Mailing Address - Country:US
Mailing Address - Phone:718-889-0978
Mailing Address - Fax:347-286-0826
Practice Address - Street 1:473 CLOVE ROAD
Practice Address - Street 2:
Practice Address - City:SI
Practice Address - State:NY
Practice Address - Zip Code:10310-2317
Practice Address - Country:US
Practice Address - Phone:718-889-0978
Practice Address - Fax:347-286-0826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management