Individual
JILL C GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1 BONNYBROOK RD, NORWALK, CT 06850-2703
(203) 247-9636
Mailing address
1 BONNYBROOK RD, NORWALK, CT 06850-2703
(203) 247-9636
(203) 956-0570
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
002713
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002713
STATE LICENSE
CT
Enumeration date
02/13/2008
Last updated
11/30/2016
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