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General NPI Number Information
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NPI Number | 1114160298
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Entity Type | Individual
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Provider Name | BRIAN E GOLDWASSER MD
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Gender | Male
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Dates
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Enumeration Date | 04/20/2009
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 125 LOGANS FERRY RD STE 2
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City | LOWER BURRELL
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State | PA
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Zip | 15068-2048
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Country | US
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Telephone | 249-944-7407
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Fax | 724-994-4745
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Provider Business Mailing Address
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Address Line | 125 LOGANS FERRY RD
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City | NEW KENSINGTON
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State | PA
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Zip | 15068-2048
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Country | US
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Telephone |
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Fax |
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD436652
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD436652
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License Number State | PA
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