MEDICARE: GOOD CARE AGENCY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	1873L	NY

General Provider Information

NPI Number	:	1447510326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD CARE AGENCY INC

Provider Business Mailing Address
First Line	:	2671 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5004
Country	:	US
Telephone Number	:	718-635-3535
Fax Number	:	718-648-2020

Provider Business Practice Location Address
First Line	:	2671 CONEY ISLAND AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5004
Country	:	US
Telephone Number	:	718-635-3535
Fax Number	:	718-648-2020

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	MS. ELENA OKHOTNIKOVA
Credential	:
Telephone Number	:	718-635-3535

Provider Enumeration Date	:	05/24/2012
Last Update Date	:	07/07/2022

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