Organization
GOLDIS GERIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL GOLDIS MD (OWNER)
(856) 346-3469
Entity
Organization
Contact information
Practice address
119 E LAUREL RD, STRATFORD, NJ 08084-1324
(856) 346-3469
Mailing address
119 E LAUREL RD, STRATFORD, NJ 08084-1324
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
25MB05768800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6141005
—
NJ
Enumeration date
04/08/2016
Last updated
04/08/2016
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