Sunrise Senior Service LLC

Primary specialty

Adult Development & Aging PsychologistTaxonomy code 103TA0700X

Legal business name

SUNRISE SENIOR SERVICE LLC

Practice address

3520 146TH St FL 2
Flushing, NY 11354-4267

Phone

(929) 595-6013

NPI assigned

Jul 30, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Taeyoung SongNPI 1114843844

Title

President

Phone

(929) 595-6013

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Taeyoung Song

  • Adult Day Care Clinic/Center
  • Flushing, NY
  • NPI 1114843844
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1396223780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3520 146TH ST FL 2",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544267",
            "telephone_number": "929-595-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 146TH ST FL 2",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113544267",
            "telephone_number": "929-595-6013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE SENIOR SERVICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "TAEYOUNG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "929-595-6013",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Development & Aging Psychologist in Flushing, NY
• Providers in Flushing, NY by specialty
• Adult Development & Aging Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.