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General NPI Number Information
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NPI Number | 1104822857
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Entity Type | Individual
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Provider Name | FREDRIC HOWARD GOLDBERG MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2005
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Last Update Date | 01/06/2023
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Provider Practice Location Address
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Address Line | 380 OXFORD VALLEY RD
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City | LANGHORNE
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State | PA
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Zip | 19047-8304
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Country | US
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Telephone | 215-949-5311
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Fax | 215-949-5317
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Provider Business Mailing Address
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Address Line | PO BOX 8500-6335
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City | PHILADELPHIA
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State | PA
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Zip | 19178-6335
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Country | US
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Telephone | 215-807-8000
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Fax | 215-949-5317
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD-042377-L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | MD042377L
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA08301300
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License Number State | NJ
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