Organization
GOLDEN AGE ADULT SERVICES. CRP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS GALINA MARKOVICH NP (NURSE PRACTITIONER)
(646) 306-7040
Entity
Organization
Contact information
Practice address
21 CANDLE LN, EAST BRUNSWICK, NJ 08816
(646) 306-7040
Mailing address
21 CANDLE LN, EAST BRUNSWICK, NJ 08816
(646) 306-7040
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
476435-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F304085
CERTIFICATE
NY
Enumeration date
04/20/2010
Last updated
04/20/2010
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