Organization
FUNCDE, LLC
Active
Other names
Functional Endocrinology
Organization subpart
No
Provider details
NPI number
Authorized official
NAILA M GOLDENBERG MD (PRACTICE OWNER)
(513) 604-1004
Entity
Organization
Contact information
Practice address
969 READING RD STE N, MASON, OH 45040
(513) 604-1004
(513) 437-0571
Mailing address
969 READING RD STE N, MASON, OH 45040-2654
(513) 604-1004
(513) 437-0571
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0079958
—
OH
05
—
0233942
—
OH
05
—
7100510650
—
KY
Enumeration date
06/18/2017
Last updated
04/22/2020
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