Provider Demographics
NPI:1124180757
Name:BRUNO GOLDEN, BARBARA FLORENCE (EDD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:FLORENCE
Last Name:BRUNO GOLDEN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 SARGENT ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458
Mailing Address - Country:US
Mailing Address - Phone:617-965-4451
Mailing Address - Fax:617-965-6801
Practice Address - Street 1:151 SARGENT ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-2338
Practice Address - Country:US
Practice Address - Phone:617-965-4451
Practice Address - Fax:617-965-6801
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3748103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0518115Medicaid
MA0518115Medicaid