Provider Demographics
NPI:1891038261
Name:STOCKBURGER GOLDBERG, AMY (RN)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:STOCKBURGER GOLDBERG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2861 S EAGLE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1546
Mailing Address - Country:US
Mailing Address - Phone:215-968-5800
Mailing Address - Fax:215-968-5899
Practice Address - Street 1:2861 S EAGLE RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-1546
Practice Address - Country:US
Practice Address - Phone:215-968-5800
Practice Address - Fax:215-968-5899
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN311286L163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant