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NPI Code Detail

MEDICARE: GRATSIANA GOLIN M.D.

MEDICARE: GRATSIANA GOLIN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician25MA04785900NJ

General Provider Information

NPI Number : 1174557300
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRATSIANA GOLIN M.D.
Provider Business Mailing Address
First Line : 3 APPLE HILL CT
Second Line :
City : MONTVALE
State : NJ
Zip : 07645-1145
Country : US
Telephone Number : 201-802-9877
Fax Number :
Provider Business Practice Location Address
First Line : 301 SICOMAC AVE
Second Line :
City : WYCKOFF
State : NJ
Zip : 07481-2159
Country : US
Telephone Number : 201-848-5200
Fax Number : 201-848-7046
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 07/08/2007

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