Provider Demographics
NPI:1417948654
Name:GOLDMAN, MARIA R (CRNP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:R
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MEMORIAL AVE
Mailing Address - Street 2:CARROLL HOSPITAL CENTER
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157
Mailing Address - Country:US
Mailing Address - Phone:410-871-6157
Mailing Address - Fax:410-871-7199
Practice Address - Street 1:200 MEMORIAL AVE
Practice Address - Street 2:CARROLL HOSPITAL CENTER
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5726
Practice Address - Country:US
Practice Address - Phone:410-871-6157
Practice Address - Fax:410-871-7199
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR086376363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDK6686480Medicare PIN