Provider Demographics
NPI:1144417338
Name:GOLDMAKHER, GREGORY V (MD, PHD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:V
Last Name:GOLDMAKHER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 VALLEY RD APT B46
Mailing Address - Street 2:
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2222
Mailing Address - Country:US
Mailing Address - Phone:617-694-4323
Mailing Address - Fax:
Practice Address - Street 1:600 VALLEY RD APT B46
Practice Address - Street 2:
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2222
Practice Address - Country:US
Practice Address - Phone:617-694-4323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2331762085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology