Organization
SI SENIOR CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUK HAN TAI (PRESIDENT)
(347) 886-9791
Entity
Organization
Contact information
Practice address
364 BAY ST, STATEN ISLAND, NY 10301-3267
(917) 780-0002
Mailing address
691 TOMPKINS AVE, STATEN ISLAND, NY 10305-3033
(917) 780-0002
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
09/26/2017
Last updated
09/26/2017
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