St Mark Senior Center of Long Island

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

Legal business name

ST MARK SENIOR CENTER OF LONG ISLAND

Doing business as

St Mark Social Adult Day care

Practice address

90 Woodbury Rd
Woodbury, NY 11797-1419

Phone

(516) 367-1328

Fax

(516) 367-7996

NPI assigned

Feb 21, 2019

Last updated

Feb 21, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Guirguis Tadros

Title

Ceo

Phone

(516) 367-1328

Specialties & licenses 1

Addresses

Other names 1

• St Mark Social Adult Day care Doing business as

Locations

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550707200000",
    "number": "1790242170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 WOODBURY RD",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971419",
            "telephone_number": "516-367-1328",
            "fax_number": "516-367-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 WOODBURY RD",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971419",
            "telephone_number": "516-367-1328",
            "fax_number": "516-367-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARK SENIOR CENTER OF LONG ISLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-21",
        "last_updated": "2019-02-21",
        "status": "A",
        "authorized_official_last_name": "TADROS",
        "authorized_official_first_name": "GUIRGUIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "516-367-1328"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Mark Social Adult Day care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Adult Day Care Clinic/Center in Woodbury, NY
• Providers in Woodbury, NY by specialty
• Adult Day Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.