Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 005737 | CT |
NPI | 1023320983 |
---|---|
Provider Name | Amy G Golden |
First Address | Farmington, CT 06032-2573 |
Second Address | Madison, CT 06443-1858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2010 |
Last Update Date | 07/07/2014 |