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Organization
JOEL S. GOLDBERG
Active
Organization
JOEL S. GOLDBERG
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL S. GOLDBERG (OWNER)
(610) 494-4422
Entity
Organization
Contact information
Practice address
4015 CHICHESTER AVE, BOOTHWYN, PA 19061
(610) 404-4422
Mailing address
4015 CHICHESTER AVE, BOOTHWYN, PA 19061
(610) 404-4422
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS004415L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016128870002
—
PA
Enumeration date
05/29/2007
Last updated
01/28/2008
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