Provider Demographics
NPI:1447559927
Name:GOODLEV, ERIC ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:ROBERT
Last Name:GOODLEV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ERIC
Other - Middle Name:ROBERT
Other - Last Name:GOODMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 789967
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-9967
Mailing Address - Country:US
Mailing Address - Phone:484-622-7395
Mailing Address - Fax:484-622-7399
Practice Address - Street 1:1330 POWELL ST STE 100
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19401-3358
Practice Address - Country:US
Practice Address - Phone:484-622-7618
Practice Address - Fax:610-270-0163
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD460516207RH0002X
NY273775207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine