Basic Information
| Provider Information | |||||||||
| NPI: | 1568566214 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLDEN | ||||||||
| FirstName: | ALEX | ||||||||
| MiddleName: | BRIAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 282 WASHINGTON ST | ||||||||
| Address2: | CONNECTICUT CHILDREN'S MED. CENTER, PED. CARDIOLOGY | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061063322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8605459400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 282 WASHINGTON ST | ||||||||
| Address2: | CONNECTICUT CHILDREN'S MED. CENTER, PED. CARDIOLOGY | ||||||||
| City: | HARTFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 061063322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8605459400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2006 | ||||||||
| LastUpdateDate: | 09/12/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0202X | 54938 | CT | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 000000221027 | 01 | OH | UNISON | OTHER | 5745432 | 01 | OH | AETNA | OTHER | 1018900900001 | 05 | PA | MEDICAID | 267941 | 01 | OH | BCMH | OTHER | 736175 | 01 | OH | BUCKEYE | OTHER | 2673941 | 05 | OH | MEDICAID | P00618508 | 01 | OH | RAILROAD MEDICARE | OTHER | 363563 | 01 | OH | WELLLCARE | OTHER | 000000525961 | 01 | OH | ANTHEM | OTHER |