JACK GOLDBERG (NPI# 1548372022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548372022 |
| Entity Type | Individual |
| Full Name | JACK GOLDBERG |
| Credential | MD |
| Practice Address |
51 N. 39th Street 103a Medical Arts Building Philadelphia PA 19104-2640 |
| Practice Telephone | 2156629801 |
| Practice Fax Number | 2152433249 |
| Mailing Telephone | 2156629801 |
| Mailing Fax Number | 2152433249 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-05-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0000X |
Internal Medicine Specialization: Hematology |
MD045263E | PA | Allopathic & Osteopathic Physicians |
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
MD045263 | PA | Allopathic & Osteopathic Physicians |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
MD045263E | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770610362 | Jack Lawrence Goldberg | Optometrist | 1562 Lemoine Ave, Fort Lee, NJ 07024-5652 | 2007-02-28 |
| 1083790174 | Jack B Goldberg | Family Medicine | 4801 S Congress Ave, Suite 306, Lake Worth, FL 33461-4746 | 2006-10-31 |
| Street Address |
51 N. 39TH STREET 103A MEDICAL ARTS BUILDING |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19104-2640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518954395 | Nevena Damjanov | Internal Medicine | 51 N. 39th Street, 103a Medical Arts Building, Philadelphia, PA 19104-2640 | 2005-10-05 |
| 1356801807 | Monica Gupta | Student in an Organized Health Care Education/Training Program | 51 N. 39th Street, 6th Floor, Philadelphia, PA 19104 | 2019-03-21 |
| 1144792276 | Elizabeth Anne Larijani | Pharmacist | 51 N. 39th Street, Abramson Cancer Center, Philadelphia, PA 19104 | 2018-12-31 |
| 1518455948 | Cathrine A Stark | Student in an Organized Health Care Education/Training Program | 51 N. 39th Street, Mab 211, Philadelphia, PA 19104 | 2018-05-01 |
| 1891132726 | Allison Marian Paisley | Nurse Practitioner | 51 N. 39th Street, Philadelphia, PA 19104 | 2013-06-01 |
| 1972895365 | Laura N Medford-davis | Emergency Medicine | 51 N. 39th Street, M01, Philadelphia, PA 19104 | 2011-05-04 |
| 1023335114 | Sean D Foster | Emergency Medicine | 51 N. 39th Street, -myrin - M01, Philadelphia, PA 19104 | 2010-04-28 |
| 1750511713 | Alice A T Mcgill | Physician Assistant | 51 N. 39th Street, Mob 300, Philadelphia, PA 19104-2640 | 2009-07-23 |
| 1093949737 | Rachael Susan Truchil | Internal Medicine | 51 N. 39th Street, Philadelphia, PA 19104 | 2009-05-11 |
| 1962643254 | Christopher D O'brien | Internal Medicine | 51 N. 39th Street, Phi 1st Floor, Philadelphia, PA 19104-2640 | 2009-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770829 | Michelle Morris | Student in an Organized Health Care Education/Training Program | Dept. of Family Medicine & Community Health, 3737 Market, Philadelphia, PA 19104 | 2020-11-04 |
| 1346853041 | Spectrum Health Services, Inc. | Clinic/Center | 1415 South University Ave, Philadelphia, PA 19104 | 2020-08-24 |
| 1770104259 | Fatimah Sorefan-mangou | Student in an Organized Health Care Education/Training Program | 4 Maloney 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1114548690 | Rebecca Blaguski | Registered Nurse | The Hospital of The University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104 | 2020-05-06 |
| 1952944175 | Rebecca Miriam Barmherzig | Psychiatry & Neurology | 3501 Civic Centre Blvd, 10th Flr Ctrb, Neurology, Philadelphia, PA 19104 | 2019-10-21 |
| 1891257101 | James Paul Byrne | Surgery | Penn Presbyterian Medical Center, Division of Trauma, S, 51 N. 39th Street, Suite 120, 1st Floor Medical Office, Philadelphia, PA 19104 | 2019-04-04 |
| 1093276453 | Lauren Shreve | Student in an Organized Health Care Education/Training Program | Department of Surgery, Surgery Education - Penn Health, 3400 Spruce Street, 4 Maloney, Philadelphia, PA 19104 | 2019-03-28 |
| 1285194282 | Lauren M Christie | Student in an Organized Health Care Education/Training Program | Penn Presbyterian Medical Center, 51 N. 39th Street, Philadelphia, PA 19104 | 2019-03-25 |
| 1114487683 | Sabrina Layne | Student in an Organized Health Care Education/Training Program | 3400 Spruce Street, 100 Centrex, Philadelphia, PA 19104 | 2019-03-21 |
| 1811457310 | Kia Lor | Student in an Organized Health Care Education/Training Program | Hospital of University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104 | 2019-03-21 |
| Find all providers in zip 19104 | ||||
| Taxonomy Code | 207RH0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology |
| An internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, clotting disorders, sickle cell disease, hemophilia, leukemia and lymphoma. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144590266 | William E Barry | Internal Medicine | 508 Penny Ln, Philadelphia, PA 19111-1200 | 2012-01-05 |
| 1528292711 | Holleh Daria Husseinzadeh | Internal Medicine | 1015 Chestnut St Ste 1321, Philadelphia, PA 19107-4313 | 2009-05-04 |
| 1730126582 | Phyllis Jane Sabol | Internal Medicine | 1856 Arthur St, Philadelphia, PA 19152 | 2006-06-01 |
| 1669464327 | Linda A. Haegele | Internal Medicine | 9600 Roosevelt Blvd Ste 301, Physician Oncology, Ltd, Philadelphia, PA 19115 | 2005-08-18 |
| 1063032530 | Monique Maria Tee | Internal Medicine | 3400 Civic Center Blvd, Philadelphia, PA 19104-5127 | 2020-04-24 |
| 1891339297 | Stc Pediatrics LLC | Internal Medicine | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-10-30 |
| 1629550561 | Temple Faculty Practice Plan Inc | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2018-09-06 |
| 1497003487 | Farzana Sayani | Internal Medicine | 3400 Spruce St, 3 Dulles, Philadelphia, PA 19104-4206 | 2012-08-22 |
| 1922386317 | Nadia Dawn Ali | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2011-08-02 |
| 1518291905 | Ralph Robert Vassallo Jr. | Internal Medicine | 700 Spring Garden St, Philadelphia, PA 19123-3508 | 2009-10-01 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19104 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.