Provider Demographics
NPI:1649462318
Name:GOLDSTEIN, LAURENCE (MD)
Entity type:Individual
Prefix:DR
First Name:LAURENCE
Middle Name:
Last Name:GOLDSTEIN
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 1:3540 COUNTRYSIDE LN
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1523
Mailing Address - Country:US
Mailing Address - Phone:717-783-3620
Mailing Address - Fax:
Practice Address - Street 1:1171 S CAMERON ST
Practice Address - Street 2:ROOM 200
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-2542
Practice Address - Country:US
Practice Address - Phone:717-783-3620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014752E207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine