MEDICARE: DR. SIDNEY JACOB GOLDFARB MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	37249	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093776916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIDNEY JACOB GOLDFARB MD

Provider Business Mailing Address
First Line	:	419 N HARRISON ST
Second Line	:	STE 206
City	:	PRINCETON
State	:	NJ
Zip	:	08540-3521
Country	:	US
Telephone Number	:	609-921-3008
Fax Number	:	609-921-7533

Provider Business Practice Location Address
First Line	:	419 N HARRISON ST
Second Line	:	STE 206
City	:	PRINCETON
State	:	NJ
Zip	:	08540-3521
Country	:	US
Telephone Number	:	609-921-3008
Fax Number	:	609-921-7533

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	10/05/2015

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