Provider Demographics
NPI:1053754861
Name:MADISON ADULT CENTER
Entity type:Organization
Organization Name:MADISON ADULT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIE RU
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-886-8326
Mailing Address - Street 1:1755 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-1031
Mailing Address - Country:US
Mailing Address - Phone:212-828-3166
Mailing Address - Fax:212-828-3166
Practice Address - Street 1:1755 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-1031
Practice Address - Country:US
Practice Address - Phone:212-828-3166
Practice Address - Fax:212-828-3166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care