Provider Demographics
NPI:1720101017
Name:GOLDBERG, ERIC (PT)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 FOURTH STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150
Mailing Address - Country:US
Mailing Address - Phone:617-889-2500
Mailing Address - Fax:617-889-2511
Practice Address - Street 1:99 4TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-2358
Practice Address - Country:US
Practice Address - Phone:617-889-2500
Practice Address - Fax:617-889-2511
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist