Goldberg, Jody Fern

Goldberg, Jody Fern is an individual health care provider with primary practice located at 9037 Parsons Blvd , Jamaica NY 11432-6032. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Goldberg, Jody Fern can be contacted via phone (718) 334-6400.

Contact Information

Primary practice address
9037 Parsons Blvd Jamaica NY 11432-6032
Phone: (718) 334-6400
Fax: (718) 334-6430
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 161405 New York

Profile Details

NPI number 1700977253
LBN Legal business name Goldberg, Jody Fern
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2006
Last updated May 18th, 2015 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700977253 NPPES
New York MEDICAID 00246075

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