MEDICARE: DR. HOWARD R GOLDBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	MD073616L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033172507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD R GOLDBERG MD

Provider Business Mailing Address
First Line	:	80 LANDINGS DR
Second Line	:	SUITE 207
City	:	WASHINGTON
State	:	PA
Zip	:	15301-9408
Country	:	US
Telephone Number	:	724-225-8995
Fax Number	:	724-225-9874

Provider Business Practice Location Address
First Line	:	80 LANDINGS DR
Second Line	:	SUITE 207
City	:	WASHINGTON
State	:	PA
Zip	:	15301-9408
Country	:	US
Telephone Number	:	724-225-8995
Fax Number	:	724-225-9874

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	10/14/2016

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