Provider Demographics
NPI:1013223551
Name:GOLDBERG, WILLIAM (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 9TH ST
Mailing Address - Street 2:
Mailing Address - City:GLASSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15045-1652
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:210 9TH ST
Practice Address - Street 2:
Practice Address - City:GLASSPORT
Practice Address - State:PA
Practice Address - Zip Code:15045-1652
Practice Address - Country:US
Practice Address - Phone:412-678-5109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-22
Last Update Date:2010-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP026334L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist