Provider Demographics
NPI:1578651733
Name:DANIEL E GOLDEN DC PA
Entity Type:Organization
Organization Name:DANIEL E GOLDEN DC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-487-8771
Mailing Address - Street 1:127 QUEEN ANNE ROAD
Mailing Address - Street 2:
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00188900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T45147Medicare UPIN
000450695Medicare ID - Type Unspecified