Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD 044864 E | PA |
NPI | 1134183163 |
---|---|
Provider Name | Elliot B Goldberg |
First Address | Pittsburgh, PA 15224-1779 |
Second Address | Pittsburgh, PA 15224-1779 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 11/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0011318940003 | (05) | PA |
110053991 | RAILROAD MEDICARE (01) | PA |
C58875 | (02) |