Gofman, Leonid

Gofman, Leonid is an sole proprietor health care provider with primary practice located at 10890 Bustleton Ave Suite 107, Philadelphia PA 19116-3313. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Gofman, Leonid can be contacted via phone (215) 677-9910.

Contact Information

Primary practice address
10890 Bustleton Ave Suite 107 Philadelphia PA 19116-3313
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DS028692L Pennsylvania

Profile Details

NPI number 1265455356
LBN Legal business name Gofman, Leonid
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 26th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265455356 NPPES
Pennsylvania MEDICAID 001429794

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