Individual
JACOB R GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
97 W PARKWAY, POMPTON PLAINS, NJ 07444-1647
(973) 831-5000
(973) 831-5432
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(914) 242-1516
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
244749
NY
208M00000X
Hospitalist Physician
244749
NY
208M00000X
Hospitalist Physician
Primary
25MA08706500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02888411
—
NY
01
—
0667910001
DME
NY
01
—
P00421811
MEDICARE RAILROAD
NY
Enumeration date
07/03/2007
Last updated
11/07/2024
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