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General NPI Number Information
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NPI Number | 1578546933
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Entity Type | Individual
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Provider Name | TODD JOSEPH GOLDBERG DPM
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Gender | Male
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 11/06/2007
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Provider Practice Location Address
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Address Line | 340 LUMBER ST SUITE B
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City | LITTLESTOWN
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State | PA
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Zip | 17340-1668
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Country | US
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Telephone | 717-359-5300
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Fax | 717-359-0775
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Provider Business Mailing Address
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Address Line | 340 LUMBER ST SUITE B
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City | LITTLESTOWN
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State | PA
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Zip | 17340-1668
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Country | US
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Telephone | 717-359-5300
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Fax | 717-359-0775
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | SC003892L
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License Number State | PA
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