Provider Demographics
NPI:1558353672
Name:GOLDEN, ROBERT STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEVEN
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 1:2 NORMANSKILL BLVD
Mailing Address - Street 2:STE 204
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-1331
Mailing Address - Country:US
Mailing Address - Phone:518-439-3189
Mailing Address - Fax:
Practice Address - Street 1:562 BIG WOODS RD
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NY
Practice Address - Zip Code:12431-5108
Practice Address - Country:US
Practice Address - Phone:518-634-2113
Practice Address - Fax:518-478-9454
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4350111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT26709Medicare UPIN
NYX33491Medicare ID - Type Unspecified