Provider Demographics
NPI:1033237524
Name:GOLDBERG, BRIAN KEITH (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:KEITH
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-807-0366
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD433440208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
1911317OtherAETNA HMO
1327120OtherCIGNA HEALTHCARE
2048241OtherHIGHMARK BLUE SHIELD
1572581OtherGATEWAY HEALTH PLAN
50078679OtherKEYSTONE HEALTH PLAN CENTRAL
3528272000OtherAMERIHEALTH
3528272000OtherKEYSTONE HEALTH PLAN EAST
117838OtherGEISINGER HEALTH PLAN
2912575OtherUNITED HEALTHCARE
823127OtherFIRST PRIORITY HEALTH
50079517OtherCAPITAL BLUE CROSS
3528272000OtherINDEPENDENCE BLUE CROSS
9552149OtherAETNA PPO
50078679OtherKEYSTONE HEALTH PLAN CENTRAL