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Individual

JACK GOLDSTEIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
218C SUNSET RD, WILLINGBORO, NJ 08046-1104
(609) 877-0400
(609) 877-1682
Mailing address
1 FEDERAL ST # 200, CAMDEN, NJ 08103-1088
(856) 356-4924

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA03701800
NJ
207RG0100X
Gastroenterology Physician
Primary
25MA03701800
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0090492000
AMERIHEALHT/KEYSTONE/ IBC
NJ
01
1018864
CIGNA
NJ
01
1346033
UNITED HEALTHCARE
NJ
01
183070
AMERIHEALTH PPO/PA BS
NJ
05
1998200
NJ
01
21420
UNIVERISITY HEALTH PLAN
NJ
01
3818454
AETNA
NJ
01
3K6075
HEALTHNET, INC
NJ
01
P3641368
OXFORD
NJ
Enumeration date
08/12/2005
Last updated
05/13/2019
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