Provider Demographics
NPI:1083859268
Name:GOLUB, DEBBIE
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:
Last Name:GOLUB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WILDWOOD RD
Mailing Address - Street 2:CONDOS
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-1709
Mailing Address - Country:US
Mailing Address - Phone:914-441-1493
Mailing Address - Fax:914-301-5389
Practice Address - Street 1:16 WILDWOOD RD
Practice Address - Street 2:CONDOS
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-1709
Practice Address - Country:US
Practice Address - Phone:914-441-1493
Practice Address - Fax:914-301-5389
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253055164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse