Goldstein, Jack
Goldstein, Jack is an individual health care provider with primary practice located at 218C Sunset Rd , Willingboro NJ 08046-1104. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Goldstein, Jack can be contacted via phone (609) 877-0400.Contact Information
Primary practice address
218C Sunset Rd
Willingboro NJ 08046-1104
Phone: (609) 877-0400
Fax: (609) 877-1682
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 25MA03701800 | New Jersey |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 25MA03701800 | New Jersey |
Profile Details
| NPI number | 1114929858 |
|---|---|
| LBN Legal business name | Goldstein, Jack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 12th, 2005 |
| Last updated | May 13th, 2019 - about 5 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 | 1114929858 | NPPES |
| New Jersey | MEDICAID | 1998200 | |
| New Jersey | Other | 1018864 | |
| New Jersey | Other | P3641368 | |
| New Jersey | Other | 0090492000 | |
| New Jersey | Other | 3818454 | |
| New Jersey | Other | 183070 | |
| New Jersey | Other | 21420 | |
| New Jersey | Other | 3K6075 | |
| New Jersey | Other | 1346033 |
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