Individual
MR. BRUCE GOLDENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3400 BARRY PAUL RD, RANDALLSTOWN, MD 21133-5161
(410) 458-5868
Mailing address
2328 SWEET MEADOW RD, BALTIMORE, MD 21209-3866
(410) 458-5868
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
21561
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005262100
—
MD
01
—
653CPH
MARYLAND PARTICIPATING PR
MD
01
—
N218
BLUECHOICE PROVIDER
MD
Enumeration date
11/05/2006
Last updated
09/19/2025
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