Organization
MARINERS RESIDENCE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AVI LUSTIG (OWNER)
(917) 544-4713
Entity
Organization
Contact information
Practice address
2099 FOREST AVE, STATEN ISLAND, NY 10303-2239
(917) 544-4713
Mailing address
2099 FOREST AVE, STATEN ISLAND, NY 10303-2239
(917) 544-4713
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
08/02/2022
Last updated
08/22/2022
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