Provider Demographics
NPI:1538327499
Name:GOLDEN, DANIEL EUGENE (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:EUGENE
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 QUEEN ANNE RD
Mailing Address - Street 2:
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603-1729
Mailing Address - Country:US
Mailing Address - Phone:201-487-8771
Mailing Address - Fax:201-487-0939
Practice Address - Street 1:127 QUEEN ANNE RD
Practice Address - Street 2:
Practice Address - City:BOGOTA
Practice Address - State:NJ
Practice Address - Zip Code:07603-1729
Practice Address - Country:US
Practice Address - Phone:201-487-8771
Practice Address - Fax:201-487-0939
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJT45147Medicare UPIN