Provider Demographics
NPI:1669036141
Name:GOLDENBERG, ASHLEY BROOKE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BROOKE
Last Name:GOLDENBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 FOX HEDGE RD
Mailing Address - Street 2:
Mailing Address - City:SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-2716
Mailing Address - Country:US
Mailing Address - Phone:201-669-8976
Mailing Address - Fax:
Practice Address - Street 1:77 FOX HEDGE RD
Practice Address - Street 2:
Practice Address - City:SADDLE RIVER
Practice Address - State:NJ
Practice Address - Zip Code:07458-2716
Practice Address - Country:US
Practice Address - Phone:201-669-8976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program