Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | SC005994 | PA |
NPI | 1003064726 |
---|---|
Provider Name | Dr. Jan Golden |
First Address | Moosic, PA 18507-1001 |
Second Address | Moosic, PA 18507-1001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2008 |
Last Update Date | 20/10/2014 |