Provider Demographics
NPI:1982706131
Name:WOLKOWITZ MARKOWITZ, GOLDIE ROCHELLE
Entity Type:Individual
Prefix:
First Name:GOLDIE
Middle Name:ROCHELLE
Last Name:WOLKOWITZ MARKOWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GOLDIE
Other - Middle Name:
Other - Last Name:MARKOWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, CRNP
Mailing Address - Street 1:160 E ERIE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-1011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:160 E ERIE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-1011
Practice Address - Country:US
Practice Address - Phone:215-427-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP004277N363L00000X
MARN2355254363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics