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	1873L001	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659736486
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	:	718-513-4427

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	:	718-513-4427

Authorized Official
Title or Position	:	OFFICER
Name	:	ALEXANDER KRUTIY
Credential	:
Telephone Number	:	718-635-3535

Provider Enumeration Date	:	12/21/2015
Last Update Date	:	03/28/2018

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Directions to “GOOD CARE AGENCY, INC. ” Practice Location

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