Provider Demographics
NPI:1821363086
Name:AFFORDABLE SENIOR CARE INC
Entity Type:Organization
Organization Name:AFFORDABLE SENIOR CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VISE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAKUBOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-864-5552
Mailing Address - Street 1:1650 EASTERN PKWY
Mailing Address - Street 2:SUITE 304
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-4804
Mailing Address - Country:US
Mailing Address - Phone:718-864-5552
Mailing Address - Fax:718-732-4508
Practice Address - Street 1:10839 67TH DR
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2945
Practice Address - Country:US
Practice Address - Phone:718-864-5552
Practice Address - Fax:718-732-4508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33644343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02981579Medicaid