CLUB 55 PRESTIGE NPI 1912447905

NPI Information

  • NPI: 1912447905
  • Provider Name: CLUB 55 PRESTIGE
  • Classification: Respite Care - 385H00000X
  • Entity Type: Organization
  • Address: 6408 FLEET ST
    REGO PARK, NY
    ZIP 11374
  • Phone: (718) 275-5275

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NPI Details

CLUB 55 PRESTIGE is a respite care in Rego Park, NY. CLUB 55 PRESTIGE NPI is 1912447905. The provider is registered as an organization entity type.

The provider's business location address is:

6408 FLEET ST
REGO PARK, NY
ZIP 11374-244
Phone: (718) 275-5275
Fax: (718) 275-2652

The provider's authorized official is Lydia Musheyev .
The authorized official title is Owner-director and has the following contact phone number (718) 812-8112.

The enumeration date for this NPI number is 2/24/2017 and was last updated on 2/24/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1385H00000XRespite CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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