NPIMap

Organization Active NPI

Goldis Geriatrics PC

  • Non-Pharmacy Dispensing Site
  • Stratford, NJ
National Provider Identifier
1114381886
Registry record updated Apr 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
25MB05768800 Issued in NJ
Legal business name
GOLDIS GERIATRICS PC
Practice address
119 E Laurel Rd
Stratford, NJ 08084-1324
Phone
(856) 346-3469
NPI assigned
Apr 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael Goldis, MDNPI 1982603247
Title
Owner
Phone
(856) 346-3469

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X 25MB05768800 NJ Primary

Addresses

Primary practice location

119 E Laurel Rd
Stratford, NJ 08084-1324

Mailing address

119 E Laurel Rd
Stratford, NJ 08084-1324

Other identifiers 1

IdentifierTypeStateIssuer
6141005MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460073600000",
    "number": "1114381886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841324",
            "telephone_number": "856-346-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDIS GERIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-08",
        "last_updated": "2016-04-08",
        "status": "A",
        "authorized_official_last_name": "GOLDIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-346-3469",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NJ",
            "license": "25MB05768800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6141005",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.