Goldenberg, Ilya G
Goldenberg, Ilya G is an sole proprietor health care provider with primary practice located at 2000 Tamarack Rd , Newark OH 43055-1183. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Goldenberg, Ilya G can be contacted via phone (614) 297-1158.Contact Information
Primary practice address
2000 Tamarack Rd
Newark OH 43055-1183
Phone: (614) 297-1158
Fax: (614) 299-3406
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 35-081219 | Ohio |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 35-081219 | Ohio |
Profile Details
| NPI number | 1619976669 |
|---|---|
| LBN Legal business name | Goldenberg, Ilya G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 20th, 2005 |
| Last updated | Feb 7th, 2012 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619976669 | NPPES |
| Ohio | MEDICAID | 2378896 | |
| Ohio | Other | 7600179 | |
| Ohio | Other | 7826564 | |
| Ohio | Other | 000000259749 | |
| Ohio | Other | 2097512 |
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