Individual
DR. JONATHAN EDWARD GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
875 MASSACHUSETTS AVE, SUITE #84, CAMBRIDGE, MA 02139-3067
(617) 928-8891
Mailing address
35 WALDEN ST, APT 3F, CAMBRIDGE, MA 02140-2047
(617) 576-0875
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
8500
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W06448
BCBSMA
MA
Enumeration date
01/18/2007
Last updated
11/28/2011
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