Provider Demographics
NPI:1548228216
Name:GOLD, JEFFREY A (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:GOLD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2866 W PHILADELPHIA AVE
Mailing Address - Street 2:
Mailing Address - City:OLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19547-8922
Mailing Address - Country:US
Mailing Address - Phone:610-987-3451
Mailing Address - Fax:610-987-6809
Practice Address - Street 1:2866 W PHILADELPHIA AVE
Practice Address - Street 2:
Practice Address - City:OLEY
Practice Address - State:PA
Practice Address - Zip Code:19547-8922
Practice Address - Country:US
Practice Address - Phone:610-987-3451
Practice Address - Fax:610-987-6809
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS008788L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG57753Medicare UPIN
PA901430JPUMedicare PIN