Provider Demographics
NPI:1568566214
Name:GOLDEN, ALEX BRIAN (MD)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:BRIAN
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:282 WASHINGTON ST
Mailing Address - Street 2:CONNECTICUT CHILDREN'S MED. CENTER, PED. CARDIOLOGY
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-3322
Mailing Address - Country:US
Mailing Address - Phone:860-545-9400
Mailing Address - Fax:
Practice Address - Street 1:282 WASHINGTON ST
Practice Address - Street 2:CONNECTICUT CHILDREN'S MED. CENTER, PED. CARDIOLOGY
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-3322
Practice Address - Country:US
Practice Address - Phone:860-545-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT549382080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000221027OtherUNISON
OH5745432OtherAETNA
PA1018900900001Medicaid
OH267941OtherBCMH
OH736175OtherBUCKEYE
OH2673941Medicaid
OHP00618508OtherRAILROAD MEDICARE
OH363563OtherWELLLCARE
OH000000525961OtherANTHEM
OH267941OtherBCMH
OHGO4190522Medicare PIN
OHP00618508OtherRAILROAD MEDICARE
I59299Medicare UPIN