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Individual

MISS ANNA GOLDBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
9851 S 71ST PLZ, PAPILLION, NE 68133-2244
(402) 686-2396
Mailing address
1039 S 106TH PLZ, APT 404, OMAHA, NE 68114-4784
(847) 722-0531

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
046010577
IL
152W00000X
Optometrist
Primary
1433
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12414393
CAQH
NE
Enumeration date
07/11/2012
Last updated
07/14/2015
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