=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861525172
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAROLD J. GOLDFARB MD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2007
-----------------------------------------------------
Last Update Date | 10/22/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 501N. 17TH ST. STE. C
-----------------------------------------------------
City | ALLENTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18104-5026
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-776-1935
-----------------------------------------------------
Fax | 610-776-1488
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 501N. 17TH ST. STE. C
-----------------------------------------------------
City | ALLENTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18104-5026
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-776-1935
-----------------------------------------------------
Fax | 610-776-1488
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. HAROLD J GOLDFARB
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 610-776-1935
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332H00000X
-----------------------------------------------------
Taxonomy Name | Eyewear Supplier
-----------------------------------------------------
License Number | MD-009998-E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------