Individual
DR. SHYAMALI V GODBOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5501 OLD YORK RD, LEVY 2 WEST, PHILADELPHIA, PA 19141-3018
(215) 456-6959
(215) 456-2356
Mailing address
101 E OLNEY AVE, SUITE 400, PHILADELPHIA, PA 19120-2421
(215) 456-7000
(215) 456-2356
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
MD053000L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001474726
—
PA
Enumeration date
01/29/2007
Last updated
08/03/2015
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