ANGELO R JOHNSON
CIN: TD70777F
Date of Birth: June 12, 1950
Gender: Male
Created: Aug. 12, 2026
Address:
230 KINGSTON AVENUE 10
, BROOKLYN, NY 11213
Last Updated: Aug. 12, 2026 3:58 PM
Latest Eligibility Snapshot
Date of Service: Sept. 14, 2026
Medicaid Eligible:
Yes
Coverage: Sept. 1, 2026 — —
Plan: ELIGIBLE PCP
MCO: VILLAGE SENIOR SVC CORP PARTIAL LTC
Recertification:
Yes — Oct. 31, 2026
Code 60:
No
S1:
No