Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 4350 | NY |
NPI | 1558353672 |
---|---|
Provider Name | Dr. Robert Steven Golden |
First Address | Delmar, NY 12054-1331 |
Second Address | Freehold, NY 12431-5108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 28/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T26709 | (02) | NY |