Goldenberg, Nancy Jacobs

Goldenberg, Nancy Jacobs is an individual health care provider with primary practice located at 1619 Grant Ave , Philadelphia PA 19115-3167. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is her primary health care specialty. Goldenberg, Nancy Jacobs can be contacted via phone (215) 934-6100.

Contact Information

Primary practice address
1619 Grant Ave Philadelphia PA 19115-3167
Fax: (215) 934-6713
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD024196E Pennsylvania
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD024196E Pennsylvania

Profile Details

NPI number 1841297736
LBN Legal business name Goldenberg, Nancy Jacobs
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Apr 25th, 2014 - 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 1841297736 NPPES
Pennsylvania MEDICAID 000935088

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