Provider Demographics
NPI:1346672599
Name:GOLDEN AGE OF MANHATTAN LLC
Entity Type:Organization
Organization Name:GOLDEN AGE OF MANHATTAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAKHNIS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:718-288-5711
Mailing Address - Street 1:271 AMHERST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4116
Mailing Address - Country:US
Mailing Address - Phone:718-288-5711
Mailing Address - Fax:
Practice Address - Street 1:23 NAGLE AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-1405
Practice Address - Country:US
Practice Address - Phone:718-338-6300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care