Active NPI
Golden Age Adult Daycare, LLC
- Adult Day Care Clinic/Center
- Brooklyn, NY
National Provider Identifier
1629312715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Day Care Clinic/Center
- Legal business name
- GOLDEN AGE ADULT DAYCARE, LLC
- Practice address
- 1773 Broadway
Brooklyn, NY 11207-1611 - Phone
- (718) 576-6336
- NPI assigned
- Nov 15, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Russel Gladkovitser
- Title
- Ceo
- Phone
- (718) 576-6336
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Day Care Clinic/Center | 261QA0600X | Primary |
Addresses
Primary practice location
1773 Broadway
Brooklyn, NY 11207-1611
Mailing address
1773 Broadway
Brooklyn, NY 11207-1611
Phone (718) 576-6336
National Provider Directory
National Provider DirectoryLocations
1773 Broadway
Brooklyn, NY 11207
Phone (718) 576-6336
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352937600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1352937600000",
"number": "1629312715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1773 BROADWAY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112071611",
"telephone_number": "718-576-6336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1773 BROADWAY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112071611",
"telephone_number": "718-576-6336"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOLDEN AGE ADULT DAYCARE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-11-15",
"last_updated": "2012-11-15",
"status": "A",
"authorized_official_last_name": "GLADKOVITSER",
"authorized_official_first_name": "RUSSEL",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "718-576-6336"
},
"taxonomies": [
{
"code": "261QA0600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Day Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.