Provider Demographics
NPI:1578700969
Name:GOLSON, ROBIN DEBRA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:DEBRA
Last Name:GOLSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 AVENUE C
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-1403
Mailing Address - Country:US
Mailing Address - Phone:201-230-8660
Mailing Address - Fax:
Practice Address - Street 1:325 AVENUE C
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-1403
Practice Address - Country:US
Practice Address - Phone:201-230-8660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017800-1103TC0700X
NJ35S100497900103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical