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General NPI Number Information
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NPI Number | 1407233836
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Entity Type | Individual
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Provider Name | ALISON REBECCA GOLDENBERG MD.
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Gender | Female
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 09/07/2021
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Provider Practice Location Address
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Address Line | 15195 HEATHCOTE BLVD STE 330
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City | HAYMARKET
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State | VA
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Zip | 20169-6244
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Country | US
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Telephone | 571-284-3380
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Fax | 571-284-3389
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Provider Business Mailing Address
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Address Line | PO BOX 936952
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City | ATLANTA
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State | GA
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Zip | 31193-6952
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 85247
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101273087
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License Number State | VA
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