Individual
AUDREY H. GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8340 E MARLENA CIR N, TUCSON, AZ 85715-4457
(520) 991-0561
Mailing address
8340 E MARLENA CIR N, TUCSON, AZ 85715-4457
(520) 991-0561
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1587
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005472
GROUP MEDICAID ID
AZ
01
—
1518948207
PHYSCIAN ASSISTANT INDIVIDUAL NPI
AZ
05
—
157984
—
AZ
01
—
1841261989
GROUP NPI
AZ
01
—
CS7943
GROUP MEDICARE RAILROAD ID & PTAN
AZ
01
—
P00735788
MEDICARE RAILROAD
AZ
01
—
ZWCBBM
GROUP MEDICARE ID
AZ
Enumeration date
11/09/2005
Last updated
08/18/2015
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