Healthcare Provider Details

I. General information

NPI: 1427332816
Provider Name (Legal Business Name): NEW YORK GOLDEN EAGLE SENIOR CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 PRINCE ST FL 2
FLUSHING NY
11354-4002
US

IV. Provider business mailing address

3636 PRINCE ST FL 2
FLUSHING NY
11354-4002
US

V. Phone/Fax

Practice location:
  • Phone: 718-460-1888
  • Fax: 718-460-3888
Mailing address:
  • Phone: 718-460-1888
  • Fax: 718-460-3888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LIPING LOBATO
Title or Position: DIRECTOR
Credential:
Phone: 718-460-1888