Healthcare Provider Details

I. General information

NPI: 1063530335
Provider Name (Legal Business Name): ISABEL GOLDENBERG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 21ST STREET, NW GROUND FLOOR
WASHINGTON DC
20052
US

IV. Provider business mailing address

800 21ST STREET, NW, COLONIAL HEALTH CENTER GROUND FLOOR
WASHINGTON DC
20052
US

V. Phone/Fax

Practice location:
  • Phone: 202-994-5300
  • Fax: 202-994-2622
Mailing address:
  • Phone: 202-994-5300
  • Fax: 202-994-2622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberMD11473
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: