MEDICARE: ASSOCIATION FOR SERVICES FOR THE AGED

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

General Provider Information

NPI Number	:	1477639904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATION FOR SERVICES FOR THE AGED

Provider Business Mailing Address
First Line	:	3636 33RD ST
Second Line	:	SUITE 305
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-2329
Country	:	US
Telephone Number	:	718-707-9696
Fax Number	:	718-707-3290

Provider Business Practice Location Address
First Line	:	3636 33RD ST
Second Line	:	SUITE 305
City	:	LONG ISLAND CITY
State	:	NY
Zip	:	11106-2329
Country	:	US
Telephone Number	:	718-707-9696
Fax Number	:	718-707-3290

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	MRS. MAUREEN FORSTER
Credential	:	R.N.
Telephone Number	:	718-707-9696

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	08/22/2020

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