Provider Demographics
NPI:1154329118
Name:GOLDMAN, HARLAN MATTHEW (DC)
Entity Type:Individual
Prefix:MR
First Name:HARLAN
Middle Name:MATTHEW
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10475 PERRY HIGHWAY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090
Mailing Address - Country:US
Mailing Address - Phone:724-935-7440
Mailing Address - Fax:724-934-4766
Practice Address - Street 1:8001 ROWAN RD
Practice Address - Street 2:SUITE 216
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066
Practice Address - Country:US
Practice Address - Phone:724-772-7440
Practice Address - Fax:724-776-9399
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC8636111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAGO1310247OtherBCBS
PA30299OtherUMPC
PA11183316OtherCAQH
PA2150317OtherFIRST HEALTH
PA7503594OtherAETNA
PA7503594OtherAETNA
PA30299OtherUMPC
PA86880Medicare UPIN