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General NPI Number Information
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NPI Number | 1699019620
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Entity Type | Organization
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Legal Business Name | GOLDEN AGE OF BROOKLYN, LLC
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 9305 AVENUE L
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City | BROOKLYN
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State | NY
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Zip | 11236-4806
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Country | US
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Telephone | 347-946-2863
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Fax |
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Provider Business Mailing Address
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Address Line | 9305 AVENUE L
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City | BROOKLYN
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State | NY
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Zip | 11236-4806
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Country | US
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Telephone | 718-272-2400
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Fax | 718-272-2410
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL GANZ
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Credential |
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Telephone | 718-272-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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