MEDICARE: LATER YEARS GERIATRIC CONSULTING SERVICES

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	364SG0600X	Gerontology Clinical Nurse Specialist

General Provider Information

NPI Number	:	1164300745
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LATER YEARS GERIATRIC CONSULTING SERVICES

Provider Business Mailing Address
First Line	:	1099 OLYMPIA RD
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-1938
Country	:	US
Telephone Number	:	516-663-0333
Fax Number	:	870-396-5913

Provider Business Practice Location Address
First Line	:	1099 OLYMPIA RD
Second Line	:
City	:	NORTH BELLMORE
State	:	NY
Zip	:	11710-1938
Country	:	US
Telephone Number	:	516-663-0333
Fax Number	:	870-396-5913

Authorized Official
Title or Position	:	OWNER
Name	:	LUZ GARGIULLO
Credential	:	NP
Telephone Number	:	516-663-0333

Provider Enumeration Date	:	08/22/2025
Last Update Date	:	08/22/2025

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