Dervish Social Adult Day Care Inc

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

Legal business name

DERVISH SOCIAL ADULT DAY CARE INC

Practice address

2060 Wallace Ave
Bronx, NY 10462-3006

Phone

(929) 293-4579

Fax

(718) 421-0003

NPI assigned

Apr 11, 2023

Organization subpart

No

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

Authorized official

Name

Jennifer Baden-Ahmed, NP

Title

Excitive Director

Phone

(347) 925-8914

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1902592215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 RICHMOND RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103042410",
            "telephone_number": "929-293-4579",
            "fax_number": "718-421-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 WALLACE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104623006",
            "telephone_number": "929-293-4579",
            "fax_number": "718-421-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERVISH SOCIAL ADULT DAY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "BADEN-AHMED",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "EXCITIVE DIRECTOR",
        "authorized_official_telephone_number": "347-925-8914",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna M Derosa, DC
• Tara Marie Derosa
• Gilead Derose, PA-C
• Joseph J Derose, MD
• Jonathan Paul Derryberry
• Pranvera Dervishi, PA
• Aditi Desai, MD
• Ajay N Desai, PHARMD
• Dhvani Desai, PHARMD
• Dinesh K. Desai, RPH

• Prevention Professional in Bronx, NY
• Providers in Bronx, NY by specialty
• Prevention Professional in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.