Healthcare Provider Details

I. General information

NPI: 1831119544
Provider Name (Legal Business Name): DAVID W. GOLDSTEIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 MARLTON PIKE E
CHERRY HILL NJ
08003-1202
US

IV. Provider business mailing address

PO BOX 416210
BOSTON MA
02241-6210
US

V. Phone/Fax

Practice location:
  • Phone: 856-616-8600
  • Fax:
Mailing address:
  • Phone: 856-616-8600
  • Fax: 856-616-8601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberOS007587L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMB4650239
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: