Provider Demographics
NPI:1174868038
Name:GOLDSMITH, JOYCE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:
Last Name:GOLDSMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 HENFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1560
Mailing Address - Country:US
Mailing Address - Phone:856-266-1201
Mailing Address - Fax:
Practice Address - Street 1:205 HENFIELD AVE
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1560
Practice Address - Country:US
Practice Address - Phone:856-266-1201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035612E208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD035612EOtherMEDICAL LICENSE
A80864Medicare UPIN