Provider Demographics
NPI:1164995940
Name:GOLDEN SERVICE GROUP CORP
Entity Type:Organization
Organization Name:GOLDEN SERVICE GROUP CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YANG GENG
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-362-2888
Mailing Address - Street 1:13443 MAPLE AVE STE C1B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-4780
Mailing Address - Country:US
Mailing Address - Phone:929-362-2888
Mailing Address - Fax:929-200-7799
Practice Address - Street 1:13443 MAPLE AVE STE C1B
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-4780
Practice Address - Country:US
Practice Address - Phone:929-362-2888
Practice Address - Fax:929-200-7799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-04
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation