Provider Demographics
NPI:1649205386
Name:GOLDBERG, ROCHELLE (MD)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E. LANCASTER AVE/ LANKENAU MED BLDG WEST; SUITE 230
Mailing Address - Street 2:PULMONOLOGY ASSOCIATES
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096
Mailing Address - Country:US
Mailing Address - Phone:610-642-3796
Mailing Address - Fax:610-642-2943
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:PULMONOLOGY ASSOCIATES SUITE 230
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-642-3796
Practice Address - Fax:610-642-2943
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030111E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA004800OtherBLUE CROSS
PA0009666560013Medicaid
PA0009666560013Medicaid