Provider Demographics
NPI:1457746653
Name:SENIOR D.C. MANAGEMENT USA CORP
Entity type:Organization
Organization Name:SENIOR D.C. MANAGEMENT USA CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SUNG
Authorized Official - Middle Name:ALEX
Authorized Official - Last Name:KO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-460-1777
Mailing Address - Street 1:13682 39TH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5515
Mailing Address - Country:US
Mailing Address - Phone:718-460-1777
Mailing Address - Fax:718-460-1779
Practice Address - Street 1:13682 39TH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5515
Practice Address - Country:US
Practice Address - Phone:718-460-1777
Practice Address - Fax:718-460-1779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care