1356784979 NPI number — MY HOME DAY CARE CENTER INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356784979 NPI number — MY HOME DAY CARE CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MY HOME DAY CARE CENTER INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1356784979
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
511 EVERGREEN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11221
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-452-3469
Provider Business Mailing Address Fax Number:
718-305-6731

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
511 EVERGREEN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-452-3469
Provider Business Practice Location Address Fax Number:
718-305-6731
Provider Enumeration Date:
04/12/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BOGOMILSKY
Authorized Official First Name:
CHAYA
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
PROGRAM DIRECTOR
Authorized Official Telephone Number:
718-452-3469

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QA0600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)