MEDICARE: MS. BARBARA ANN GOLDMAN C.O.

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	174H00000X	Health Educator	CO004236	PA
2	174H00000X	Health Educator	C19355	PA

General Provider Information

NPI Number	:	1962726877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BARBARA ANN GOLDMAN C.O.

Provider Business Mailing Address
First Line	:	437 MAIN ST
Second Line	:	FIRST FLOOR
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-2597
Country	:	US
Telephone Number	:	570-421-1110
Fax Number	:	570-421-1207

Provider Business Practice Location Address
First Line	:	437 MAIN ST
Second Line	:	FIRST FLOOR
City	:	STROUDSBURG
State	:	PA
Zip	:	18360-2597
Country	:	US
Telephone Number	:	570-421-1110
Fax Number	:	570-421-1207

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

Provider Enumeration Date	:	03/22/2010
Last Update Date	:	03/22/2010

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