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Individual

MOLLIE BASH GOLDENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
33 SEWALL ST, PORTLAND, ME 04102-2603
(207) 828-2100
(207) 553-7166
Mailing address
324 GANNETT DR STE 200, SOUTH PORTLAND, ME 04106-3266
(207) 482-7800
(207) 482-7898

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA1636
ME
363AS0400X
Surgical Physician Assistant
C5-0000969
DE
363AS0400X
Surgical Physician Assistant
Primary
PA1636
ME

Other

Enumeration date
09/24/2014
Last updated
04/14/2026
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