Provider Demographics
NPI:1669431045
Name:DARYL G. COLDEN M.D.
Entity type:Organization
Organization Name:DARYL G. COLDEN M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:G
Authorized Official - Last Name:COLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:978-685-2900
Mailing Address - Street 1:PO BOX 2200
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-4200
Mailing Address - Country:US
Mailing Address - Phone:603-673-9411
Mailing Address - Fax:603-673-9899
Practice Address - Street 1:50 PROSPECT ST
Practice Address - Street 2:SUITE 401
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-2841
Practice Address - Country:US
Practice Address - Phone:978-685-2900
Practice Address - Fax:978-688-8292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
Not Answered207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0032003OtherNEIGHBORHOOD HEALTH
MAM18371OtherBLUE CROSS BLUE SHIELD
MA0032003OtherNEIGHBORHOOD HEALTH
MA=========OtherTRICARE