MEDICARE: GOLDEN AGE OF BROOKLYN, LLC

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	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1699019620
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN AGE OF BROOKLYN, LLC

Provider Business Mailing Address
First Line	:	9305 AVENUE L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4806
Country	:	US
Telephone Number	:	718-272-2400
Fax Number	:	718-272-2410

Provider Business Practice Location Address
First Line	:	9305 AVENUE L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-4806
Country	:	US
Telephone Number	:	347-946-2863
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. MICHAEL GANZ
Credential	:
Telephone Number	:	718-272-2400

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	10/23/2025

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