Provider Demographics
NPI:1649213943
Name:GOLDBARG, JEFFREY ROBBINS (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ROBBINS
Last Name:GOLDBARG
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 1:14 VERNON ST
Mailing Address - Street 2:STE 206
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4783
Mailing Address - Country:US
Mailing Address - Phone:508-626-0076
Mailing Address - Fax:508-626-0546
Practice Address - Street 1:14 VERNON ST
Practice Address - Street 2:STE 206
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-4783
Practice Address - Country:US
Practice Address - Phone:508-626-0076
Practice Address - Fax:508-626-0546
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA382832084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
38283OtherMA LICENSE
MAB48158Medicare ID - Type Unspecified
B73255Medicare UPIN