Provider Demographics
NPI:1558427401
Name:GULDEN, CLAIRE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CLAIRE
Middle Name:
Last Name:GULDEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 LACEY ROAD
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-2511
Mailing Address - Country:US
Mailing Address - Phone:609-693-8900
Mailing Address - Fax:609-971-2888
Practice Address - Street 1:1001 LACEY RD
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-1042
Practice Address - Country:US
Practice Address - Phone:609-693-8900
Practice Address - Fax:609-971-2888
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00022600363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MP00022600OtherLICENSE #
NJA00028400OtherCDS #
NJMG1342269OtherDEA #
NJ071352Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID #