Provider Demographics
NPI:1003268400
Name:GOLDEN AGE HOME CARE
Entity Type:Organization
Organization Name:GOLDEN AGE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-449-5983
Mailing Address - Street 1:831 BURKE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-6613
Mailing Address - Country:US
Mailing Address - Phone:347-449-5983
Mailing Address - Fax:347-275-9834
Practice Address - Street 1:140 CASALS PL
Practice Address - Street 2:SUITE 30L
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10475-3202
Practice Address - Country:US
Practice Address - Phone:914-412-8096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-08
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1826L251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health