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Individual
ILYA G GOLDENBERG
Active
Individual
ILYA G GOLDENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-081219
OH
208M00000X
Hospitalist Physician
Primary
35-081219
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000259749
ANTHEM
OH
01
—
2097512
FIRST HEALTH
OH
05
—
2378896
—
OH
01
—
7600179
UHC
OH
01
—
7826564
AETNA
OH
Enumeration date
07/20/2005
Last updated
02/07/2012
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