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General NPI Number Information
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NPI Number | 1588715684
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Entity Type | Organization
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Legal Business Name | GOLDEN GERIATRICS
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 200 S BROADWAY SUITE 106
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City | TARRYTOWN
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State | NY
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Zip | 10591-4500
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Country | US
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Telephone | 914-366-6821
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Fax | 914-366-0641
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Provider Business Mailing Address
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Address Line | 3 W MAIN ST
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City | GOLDENS BRIDGE
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State | NY
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Zip | 10526-1129
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Country | US
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Telephone | 914-301-5044
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Fax | 914-366-0641
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Authorized Official
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Title or Position | CEO
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Name | CATHERINE J HARRIS
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Credential | NP
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Telephone | 914-301-5044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | F430089
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License Number State | NY
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