Basic Information
| Provider Information | |||||||||
| NPI: | 1235711839 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GOLDEN INSIGHT INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 WEBSTER ST STE 8 | ||||||||
| Address2: | |||||||||
| City: | HANOVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023391227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7816603090 | ||||||||
| FaxNumber: | 7815360016 | ||||||||
| Practice Location | |||||||||
| Address1: | 105 WEBSTER ST STE 8 | ||||||||
| Address2: | |||||||||
| City: | HANOVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023391227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7813127457 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2021 | ||||||||
| LastUpdateDate: | 06/03/2022 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | BROWN | ||||||||
| AuthorizedOfficialFirstName: | SARINAH | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7813127457 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CNP | ||||||||
| NPICertificationDate: | 06/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0808X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.