Organization
V. GOSWAMI, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VARDHANA GOSWAMI M.D. (OWNER)
(215) 949-1103
Entity
Organization
Contact information
Practice address
333 N OXFORD VALLEY RD, #104, FAIRLESS HILLS, PA 19030-2624
(215) 949-1103
(215) 364-1708
Mailing address
333 N OXFORD VALLEY RD, #104, FAIRLESS HILLS, PA 19030-2624
(215) 949-1103
(215) 364-1708
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD066830L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1377301
HIGHMARK BLUE SHIELD
PA
01
—
2074841001
INDEPENDENCE BLUE CROSS
PA
Enumeration date
07/01/2006
Last updated
06/04/2010
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