Goldenberg, Ilya G

Goldenberg, Ilya G is an sole proprietor health care provider with primary practice located at 2000 Tamarack Rd , Newark OH 43055-1183. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Goldenberg, Ilya G can be contacted via phone (614) 297-1158.

Contact Information

Primary practice address
2000 Tamarack Rd Newark OH 43055-1183
Phone: (614) 297-1158
Fax: (614) 299-3406
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35-081219 Ohio
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 35-081219 Ohio

Profile Details

NPI number 1619976669
LBN Legal business name Goldenberg, Ilya G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 20th, 2005
Last updated Feb 7th, 2012 - about 12 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 1619976669 NPPES
Ohio MEDICAID 2378896
Ohio Other 7600179
Ohio Other 7826564
Ohio Other 000000259749
Ohio Other 2097512

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