Provider Demographics
NPI:1124180138
Name:GOLDEN, ANN (NP)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 49TH ST
Mailing Address - Street 2:SUNSET TERRACE
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-2010
Mailing Address - Country:US
Mailing Address - Phone:718-431-2649
Mailing Address - Fax:718-437-5239
Practice Address - Street 1:514 49TH ST
Practice Address - Street 2:SUNSET TERRACE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-2010
Practice Address - Country:US
Practice Address - Phone:718-431-2649
Practice Address - Fax:718-437-5239
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF400161363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health