Provider Demographics
NPI:1508269531
Name:GOLDEN YEARS SENIOR PROGRAM INC.
Entity Type:Organization
Organization Name:GOLDEN YEARS SENIOR PROGRAM INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAYENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-739-8732
Mailing Address - Street 1:7414 263RD ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1113
Mailing Address - Country:US
Mailing Address - Phone:347-739-8732
Mailing Address - Fax:
Practice Address - Street 1:25820 HILLSIDE AVENUE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11004
Practice Address - Country:US
Practice Address - Phone:347-739-8732
Practice Address - Fax:718-740-9707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-05
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care