Provider Demographics
NPI:1932640026
Name:NJ GOLDEN HOME CARE
Entity Type:Organization
Organization Name:NJ GOLDEN HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HATEM
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDELAZIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-918-5521
Mailing Address - Street 1:815 ELIZABETH AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07201-2749
Mailing Address - Country:US
Mailing Address - Phone:973-390-8768
Mailing Address - Fax:201-984-0700
Practice Address - Street 1:815 ELIZABETH AVE
Practice Address - Street 2:STE 301
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07201-2749
Practice Address - Country:US
Practice Address - Phone:973-390-8768
Practice Address - Fax:201-984-0700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0547166Medicaid