Individual
ROBERT J GOLDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
175 E CHESTER PIKE, RIDLEY PARK, PA 19078-2284
(215) 442-5085
(877) 329-2370
Mailing address
PO BOX 650782, DALLAS, TX 75265-0782
(302) 733-0806
(302) 733-0854
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN505068L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001910860
—
PA
01
—
053606
AANA NUMBER
PA
01
—
P00835760
RAILROAD MEDICARE PTAN
PA
Enumeration date
09/13/2005
Last updated
07/02/2012
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