Provider Demographics
NPI:1265938468
Name:GOLDEN HEALTH CARE CHIROPRACTIC DIAGNOSTIC PC
Entity type:Organization
Organization Name:GOLDEN HEALTH CARE CHIROPRACTIC DIAGNOSTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YIGAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SASAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:347-278-3811
Mailing Address - Street 1:289 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-6048
Mailing Address - Country:US
Mailing Address - Phone:201-368-1744
Mailing Address - Fax:201-368-4744
Practice Address - Street 1:289 MARKET ST
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-6048
Practice Address - Country:US
Practice Address - Phone:201-368-1744
Practice Address - Fax:201-368-4744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00675600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ38MC00675600OtherCHIROPRACTIC LICENSE NUMBER