Provider Demographics
NPI:1528393279
Name:GOLDBERGER, JANE L (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:L
Last Name:GOLDBERGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5025 N CENTRAL AVE # 637
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1520
Mailing Address - Country:US
Mailing Address - Phone:602-943-3100
Mailing Address - Fax:602-943-3122
Practice Address - Street 1:10000 N 31ST AVE STE D201
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-9570
Practice Address - Country:US
Practice Address - Phone:602-943-3100
Practice Address - Fax:602-943-3122
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ15622207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine