Organization Active NPI

Golden Age Adult Daycare, LLC

  • Adult Day Care Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1629312715
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
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

Updated by the provider on Nov 15, 2012

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)CodeLicenseStatePrimary
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 Directory

Locations

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.

Verify at the official NPI Registry.