Provider Demographics
NPI:1952407546
Name:GOLDFARB, OLGA (MD)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:GOLDFARB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WHITE HORSE RD STE 802
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4414
Mailing Address - Country:US
Mailing Address - Phone:856-524-7243
Mailing Address - Fax:856-524-7365
Practice Address - Street 1:1000 WHITE HORSE RD STE 802
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:856-524-7243
Practice Address - Fax:856-524-7365
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA68227208000000X
NJ25MA068227002084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0053451000OtherAMERIHEALTH/KEYSTONE/IBC
NJ000007401OtherAMERIHEALTH PPO/PA BS
NJ1945185OtherUNITED HEALTHCARE
NJ1089412OtherHORIZON NJ HEALTH
NJ20455OtherUNIVERISITY HEALTH PLAN
NJ010003751OtherAMERICHOICE
NJ2198794OtherCIGNA
NJP1113626OtherOXFORD
NJ2969215OtherAETNA
NJ3K6021OtherHEALTHNET
NJ3K6021OtherHEALTHNET
NJ1945185OtherUNITED HEALTHCARE
NJP1113626OtherOXFORD