Individual
JAMIE GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
600 N ITHAN AVE, BRYN MAWR, PA 19010-1773
(610) 658-3950
(610) 520-3919
Mailing address
54 E NEWTOWN PL, NEWARK, DE 19702-2973
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
RT004959
PA
Other
Enumeration date
12/02/2013
Last updated
12/05/2013
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