Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 60527113 | WA |
Y | 207T00000X | Neurosurgeon | MD461955 | PA |
NPI | 1003299629 |
---|---|
Provider Name | Dr. Oded Goren |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-5789 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2015 |
Last Update Date | 31/08/2020 |