Individual
DR. ILAN PHILIP GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9 MERIAM ST STE 22, LEXINGTON, MA 02420-5312
(617) 667-2300
Mailing address
12 OLIVER RD UNIT 2, WATERTOWN, MA 02472-4136
(781) 990-8349
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
234400
MA
Other
Enumeration date
04/06/2007
Last updated
08/26/2010
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