Individual
AMY GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-3996
(401) 444-3804
Mailing address
593 EDDY ST, HASBRO 122, PROVIDENCE, RI 02903-4923
(401) 444-6484
(401) 444-6378
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
10624
RI
2080C0008X
Child Abuse Pediatrics Physician
Primary
MD10624
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7009202
—
RI
Enumeration date
05/31/2006
Last updated
04/26/2016
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