Provider Demographics
NPI:1184846826
Name:GOLDENBERG, LINDA BRUSSEAU (APRN)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:BRUSSEAU
Last Name:GOLDENBERG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 OAKLAND RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2211
Mailing Address - Country:US
Mailing Address - Phone:973-650-2969
Mailing Address - Fax:
Practice Address - Street 1:224 HAMBURG TPKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2111
Practice Address - Country:US
Practice Address - Phone:973-956-3365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN06137400163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscience
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ007056Medicare ID - Type Unspecified