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General NPI Number Information
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NPI Number | 1467936864
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Entity Type | Individual
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Provider Name | LILACH GOLDSTEIN MD
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Gender | Female
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 901 WALNUT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5214
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Country | US
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Telephone | 215-955-4967
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Fax |
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Provider Business Mailing Address
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Address Line | 200 N WYNNEWOOD AVE APT B113
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City | WYNNEWOOD
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State | PA
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Zip | 19096-1405
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Country | US
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Telephone | 267-206-8747
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | LT000368
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License Number State | PA
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