Charles Goldstein, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

25MA03456800 Issued in NJ

Practice address

210 Ark Rd
Mount Laurel, NJ 08054-3188

Phone

(856) 778-8860

Fax

(609) 261-4180

NPI assigned

Aug 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1295737708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 ROUTE 38",
            "address_2": "P.O. BOX 479",
            "city": "HAINESPORT",
            "state": "NJ",
            "postal_code": "080362702",
            "telephone_number": "609-261-7017",
            "fax_number": "609-261-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 ARK RD",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080543188",
            "telephone_number": "856-778-8860",
            "fax_number": "609-261-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NJ",
            "license": "25MA03456800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0938408",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summer M Gilmore
• Taylor Ginchereau
• Samuel Nicholas Giordano, M.D.
• Alexis L Gober
• Richard F Golden, M.D.
• Daniel Todd Goldstein, M.D.
• Karla Goldstein, M.S.,R.D.N, LDN.
• Kenneth Brian Goldstein, MD.
• Jason Golowski, BCBA
• Lindsey Rae Goodenough, DPT

• All providers in Mount Laurel, NJ
• Diagnostic Radiology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; 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.