Provider Demographics
NPI:1790929305
Name:GOLDBERG, JAY A (MD)
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:A
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:339 OLD HAYMAKER RD
Mailing Address - Street 2:PARKWAY BUILDING SUITE 201
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1435
Mailing Address - Country:US
Mailing Address - Phone:412-372-2770
Mailing Address - Fax:412-372-3314
Practice Address - Street 1:339 OLD HAYMAKER RD
Practice Address - Street 2:PARKWAY BUILDING SUITE 201
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-1435
Practice Address - Country:US
Practice Address - Phone:412-372-2770
Practice Address - Fax:412-372-3314
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD029504E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology