Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mariners Residence Inc

Organization Adult Care Home Facility · NPI 1639806490

Mariners Residence Inc is an Adult Care Home Facility in Staten Island, New York. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2099 Forest Ave
Staten Island, NY 10303-2239
Phone: (917) 544-4713
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Care Home Facility (primary) Taxonomy 311ZA0620X

Record details

NPI number1639806490
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Avi Lustig — Owner · (917) 544-4713
NPI enumeratedAugust 2, 2022
Last updated in NPPESAugust 22, 2022
Certification dateAugust 22, 2022
Mailing address2099 Forest Ave, Staten Island, NY 10303-2239

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