Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 25MA0524400 | NJ |
N | 207Q00000X | Family Doctor | 25MA05244400 | NJ |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 25MA0524400 | NJ |
Y | 207RH0002X | Hospice and Palliative Medicine | 25MA05244400 | NJ |
NPI | 1578608162 |
---|---|
Provider Name | Stephen P Goldfine |
First Address | Marlton, NJ 08053 |
Second Address | Marlton, NJ 08053 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 25/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2364107 | (05) | NJ |
E62681 | (02) | NJ |