Provider Demographics
NPI:1316334766
Name:GOLDEN, PAMELA (DO)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:GOLDEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:10977-8916
Mailing Address - Country:US
Mailing Address - Phone:458-354-9300
Mailing Address - Fax:
Practice Address - Street 1:7205 STONEHENGE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1649
Practice Address - Country:US
Practice Address - Phone:919-848-2229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-23
Last Update Date:2019-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY293100-1208000000X
NC247143208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics