Provider Demographics
NPI:1093863334
Name:GOLDSTEIN, MARC F (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:F
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:205 N BROAD ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-1554
Mailing Address - Country:US
Mailing Address - Phone:215-569-1111
Mailing Address - Fax:215-569-8797
Practice Address - Street 1:205 N BROAD ST
Practice Address - Street 2:SUITE 300
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1554
Practice Address - Country:US
Practice Address - Phone:215-569-1111
Practice Address - Fax:215-569-8797
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD023998E207K00000X
NJ25MA03788500207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA047470G55Medicare PIN
D19600Medicare UPIN
NJ805764DSCMedicare PIN