Provider Demographics
NPI:1659326296
Name:RICHARD S GOLDSTEIN MD
Entity Type:Organization
Organization Name:RICHARD S GOLDSTEIN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-741-4910
Mailing Address - Street 1:1203 LANGHORNE NEWTOWN RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1233
Mailing Address - Country:US
Mailing Address - Phone:215-741-4910
Mailing Address - Fax:215-741-4394
Practice Address - Street 1:1203 LANGHORNE NEWTOWN RD
Practice Address - Street 2:SUITE 130
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1233
Practice Address - Country:US
Practice Address - Phone:215-741-4910
Practice Address - Fax:215-741-4394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA624064Medicare ID - Type Unspecified