Provider Demographics
NPI:1083130744
Name:GOLDEN, JESSICA BROOKE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:BROOKE
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 AROSE LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-1936
Mailing Address - Country:US
Mailing Address - Phone:732-290-5185
Mailing Address - Fax:732-612-1410
Practice Address - Street 1:202 AROSE LN
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-1936
Practice Address - Country:US
Practice Address - Phone:732-290-5185
Practice Address - Fax:732-612-1410
Is Sole Proprietor?:No
Enumeration Date:2017-08-15
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01738300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist