Provider Demographics
NPI:1568676146
Name:GOLD & SILVER AGING HOME CARE INC
Entity Type:Organization
Organization Name:GOLD & SILVER AGING HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEONORA
Authorized Official - Middle Name:
Authorized Official - Last Name:HECTOR-SIDIBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-685-5750
Mailing Address - Street 1:1170 BROADWAY
Mailing Address - Street 2:SUITE 428
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-7507
Mailing Address - Country:US
Mailing Address - Phone:212-685-5750
Mailing Address - Fax:212-685-5754
Practice Address - Street 1:1170 BROADWAY
Practice Address - Street 2:SUITE 428
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7507
Practice Address - Country:US
Practice Address - Phone:212-685-5750
Practice Address - Fax:212-685-5754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9990L001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02054286Medicaid