Provider Demographics
NPI:1043316912
Name:GOLDSTEIN, HOWARD B (DO)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:B
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4735 OGLETOWN STANTON RD
Mailing Address - Street 2:SUITE 1208
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2072
Mailing Address - Country:US
Mailing Address - Phone:302-623-4055
Mailing Address - Fax:
Practice Address - Street 1:4735 OGLETOWN STANTON RD
Practice Address - Street 2:SUITE 1208
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-623-4055
Practice Address - Fax:302-623-4056
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07325600207V00000X
DEC2-0008063207VG0400X, 2088F0040X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyUrogynecology and Reconstructive Pelvic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0081655Medicaid
NJ3970948OtherAETNA
NJ1782266OtherAMERIHEALTH PPO/PA BS
NJ2579696000OtherAMERIHEALTH/KEYSTONE/IBC
NJP3722808OtherOXFORD
NJ010007624OtherAMERICHOICE
NJ3274382OtherCIGNA
NJ60021099OtherHORIZON NJ HEALTH
NJ2579696000OtherAMERIHEALTH/KEYSTONE/IBC
NJ3274382OtherCIGNA
NJ010007624OtherAMERICHOICE