Goldberg, Bruce A
Goldberg, Bruce A is an sole proprietor health care provider with primary practice located at 85 Constitution Lane Ste 200C Liberty Tree Park, Danvers MA 01923. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry. Allopathic & Osteopathic Physicians / Geriatric Psychiatry is his primary health care specialty. Goldberg, Bruce A can be contacted via phone (978) 750-3670.Contact Information
Primary practice address
85 Constitution Lane Ste 200C Liberty Tree Park
Danvers MA 01923
Phone: (978) 750-3670
Fax: (978) 750-3606
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 46504 | Massachusetts |
| Allopathic & Osteopathic Physicians / Geriatric Psychiatry | 2084P0805X | 46504 | Massachusetts |
Profile Details
| NPI number | 1568565190 |
|---|---|
| LBN Legal business name | Goldberg, Bruce A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 7th, 2006 |
| Last updated | May 27th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568565190 | NPPES |
| Massachusetts | MEDICAID | 3015149 | |
| Massachusetts | Other | V02758 | |
| Massachusetts | Other | 046504 |
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