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General NPI Number Information
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NPI Number | 1376527689
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Entity Type | Individual
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Provider Name | GARY L. GOLDMAN MD
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Gender | Male
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5000 W TILGHMAN ST SUITE 240
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City | ALLENTOWN
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State | PA
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Zip | 18104-9109
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Country | US
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Telephone | 800-232-2762
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Fax |
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Provider Business Mailing Address
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Address Line | 358 N FARM DR
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City | LITITZ
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State | PA
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Zip | 17543-9213
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Country | US
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Telephone | 717-560-0744
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Fax | 717-560-3819
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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 | MD024197E
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License Number State | PA
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