Provider Demographics
NPI:1639141815
Name:GOLDSTEIN, DAVID R (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7901 BUSTLETON AVENUE, SUITE 100
Mailing Address - Street 2:KRAMER OB/GYN & ASSOCIATES
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152
Mailing Address - Country:US
Mailing Address - Phone:215-543-0060
Mailing Address - Fax:215-543-0099
Practice Address - Street 1:7901 BUSTLETON AVENUE, SUITE 100
Practice Address - Street 2:KRAMER OB/GYN & ASSOCIATES
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152
Practice Address - Country:US
Practice Address - Phone:215-543-0060
Practice Address - Fax:215-543-0099
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2012-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA079240207V00000X
PAMD423541207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ094110N5TMedicare PIN
NJI41562Medicare UPIN