Provider Demographics
NPI:1194948323
Name:GOLDBERG, JOSEPH F (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:208 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-3812
Mailing Address - Country:US
Mailing Address - Phone:203-966-3561
Mailing Address - Fax:203-966-9336
Practice Address - Street 1:208 VALLEY RD
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-3812
Practice Address - Country:US
Practice Address - Phone:203-966-3561
Practice Address - Fax:203-966-9336
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0430712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTG27506Medicare UPIN