Provider Demographics
NPI:1023167376
Name:GOLDEN, FLAVIA A (MD)
Entity type:Individual
Prefix:DR
First Name:FLAVIA
Middle Name:A
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 E 71ST ST FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4894
Mailing Address - Country:US
Mailing Address - Phone:212-396-3016
Mailing Address - Fax:347-573-9028
Practice Address - Street 1:418 E 71ST ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4894
Practice Address - Country:US
Practice Address - Phone:212-396-3016
Practice Address - Fax:396-573-9028
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY190335207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF70403Medicare UPIN
NY01I856Medicare UPIN