Provider Demographics
NPI:1154368108
Name:GOLDBERG, RENEE M (MD)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:M
Last Name:GOLDBERG
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 1:157 BAY COLONY DR
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-2533
Mailing Address - Country:US
Mailing Address - Phone:781-433-0214
Mailing Address - Fax:
Practice Address - Street 1:272 CHESTNUT ST
Practice Address - Street 2:BETH ISRAEL HOSP MED CAR
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2410
Practice Address - Country:US
Practice Address - Phone:781-433-0214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA76926207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology