Provider Demographics
NPI:1881897858
Name:GOLDEN, THOMAS HUGH (PHD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:HUGH
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 RIVEREDGE RD
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-3211
Mailing Address - Country:US
Mailing Address - Phone:201-567-1913
Mailing Address - Fax:201-567-7588
Practice Address - Street 1:30 RIVEREDGE RD
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-3211
Practice Address - Country:US
Practice Address - Phone:201-567-1913
Practice Address - Fax:201-567-7588
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ850103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ699098Medicare ID - Type Unspecified