MEDICARE: LORI ANN GOLDSTEIN 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	2084P0800X	Psychiatry Physician	MD435180	PA

General Provider Information

NPI Number	:	1235294208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI ANN GOLDSTEIN MD

Provider Business Mailing Address
First Line	:	2200 BENJAMIN FRANKLIN PKWY APT N108
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-3713
Country	:	US
Telephone Number	:	267-254-2745
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 BENJAMIN FRANKLIN PKWY APT N108
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-3713
Country	:	US
Telephone Number	:	267-254-2745
Fax Number	:

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

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	11/11/2010

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