Provider Demographics
NPI:1316023229
Name:SERVICES FOR THE AGED
Entity Type:Organization
Organization Name:SERVICES FOR THE AGED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HOME CARE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOYKHBERG
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSA
Authorized Official - Phone:646-343-9300
Mailing Address - Street 1:247 WEST 37TH STREET 4TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018
Mailing Address - Country:US
Mailing Address - Phone:646-343-9300
Mailing Address - Fax:929-299-1192
Practice Address - Street 1:247 WEST 37TH STREET 4TH FLOOR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018
Practice Address - Country:US
Practice Address - Phone:646-343-9300
Practice Address - Fax:929-299-1192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00923799Medicaid
NY009223799Medicaid