Provider Demographics
NPI:1306238712
Name:GOLDMAN, SVETLANA (PHARMD)
Entity type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:827 RAINIER RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-4044
Mailing Address - Country:US
Mailing Address - Phone:440-241-4170
Mailing Address - Fax:
Practice Address - Street 1:1215 LEE ST
Practice Address - Street 2:2ND FLOOR-HEART & VASCULAR CENTER ROOM 2214
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:434-465-7042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-22
Last Update Date:2015-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202212400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist