Provider Demographics
NPI:1447826946
Name:GOLDEN AGE HOME CARE
Entity type:Organization
Organization Name:GOLDEN AGE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:NAWAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-775-7852
Mailing Address - Street 1:3789 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10465-2457
Mailing Address - Country:US
Mailing Address - Phone:646-591-8396
Mailing Address - Fax:347-275-9834
Practice Address - Street 1:3789 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2457
Practice Address - Country:US
Practice Address - Phone:646-591-8396
Practice Address - Fax:347-275-9834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health