Provider Demographics
NPI:1568558039
Name:GOLDBERG, JOAN H (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:H
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:133 BROOKLINE AVE FL 9
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3904
Mailing Address - Country:US
Mailing Address - Phone:617-421-5950
Mailing Address - Fax:617-421-6008
Practice Address - Street 1:133 BROOKLINE AVE FL 9
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3904
Practice Address - Country:US
Practice Address - Phone:617-421-5950
Practice Address - Fax:617-421-6008
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA80598207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2013762Medicaid
MA080598OtherTUFTS HEALTH PLAN
MAB11461OtherBLUE CROSS
MAPM230OtherHARVARD PILGRIM
MA39939633OtherCIGNA
MA0014910OtherNEIGHBORHOOD HEALTH PLAN
MAP00018724OtherMEDICARE RAILROAD
MAB1146101Medicare PIN
MA0014910OtherNEIGHBORHOOD HEALTH PLAN