Provider Demographics
NPI:1356329460
Name:GOLDHAMMER, HOWARD (DPM)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:GOLDHAMMER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1281 WILTON CRES
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-6011
Mailing Address - Country:US
Mailing Address - Phone:215-493-5908
Mailing Address - Fax:
Practice Address - Street 1:1304 RHAWN ST
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19111-2870
Practice Address - Country:US
Practice Address - Phone:215-742-1225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC001717L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAT29522Medicare UPIN