Active NPI
Fiesta Adult Daycare LLC
- Adult Day Care Clinic/Center
- Staten Island, NY
National Provider Identifier
1952276065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- Legal business name
- FIESTA ADULT DAYCARE LLC
- Practice address
- 2200 Victory Blvd FL 2
Staten Island, NY 10314-6624 - Phone
- (718) 814-0555
- Fax
- (718) 228-8999
- NPI assigned
- Oct 8, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tatyana F Elberg
- Title
- Administrator
- Phone
- (718) 996-0456
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | Primary |
Addresses
Primary practice location
2200 Victory Blvd FL 2
Staten Island, NY 10314-6624
Mailing address
2200 Victory Blvd FL 2
Staten Island, NY 10314-6624
Phone (718) 814-0555
National Provider Directory
National Provider Directory- Tax ID family
- Fiesta Adult Daycare LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Adult Day Care Clinic/Center
- Brooklyn, NY
- NPI 1306192042
Locations
2200 Victory Blvd
Fl 2
Staten Island, NY 10314
Phone (718) 814-0555
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759881600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759881600000",
"number": "1952276065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 VICTORY BLVD FL 2",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103146624",
"telephone_number": "718-814-0555",
"fax_number": "718-228-8999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 VICTORY BLVD FL 2",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103146624",
"telephone_number": "718-814-0555",
"fax_number": "718-228-8999"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FIESTA ADULT DAYCARE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-10-08",
"last_updated": "2025-10-08",
"certification_date": "2025-10-08",
"status": "A",
"authorized_official_last_name": "ELBERG",
"authorized_official_first_name": "TATYANA",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "718-996-0456"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.