Provider Demographics
NPI:1235241787
Name:GOLDENBERG, IRVIN FARREL (MD)
Entity Type:Individual
Prefix:DR
First Name:IRVIN
Middle Name:FARREL
Last Name:GOLDENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3640 ZENITH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-1165
Mailing Address - Country:US
Mailing Address - Phone:612-920-2252
Mailing Address - Fax:612-924-4148
Practice Address - Street 1:3640 ZENITH AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-1165
Practice Address - Country:US
Practice Address - Phone:612-920-2252
Practice Address - Fax:612-924-4148
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28272207R00000X, 207RC0000X, 207RC0001X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology