Jacki Goldstein, M.D.
Individual provider Active NPI Internal Medicine Physician · South Glastonbury, CT
NPI 1912452020 · NPPES record last updated Aug 18, 2016
Key facts
- NPI
- 1912452020
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 026132 (CT)
- Practice address
- 40 Old Farms Rd
South Glastonbury, CT 06073-3714 - Phone
- (860) 833-5732
- NPI assigned
- Aug 18, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 026132 | CT | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 026132 | CT | Yes |
Addresses
Primary practice location
40 Old Farms Rd
South Glastonbury, CT 06073-3714
Mailing address
40 Old Farms Rd
South Glastonbury, CT 06073-3714
Phone (860) 833-5732
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- Meryl Marci Fields
- Alicia Folland-Tillinghast
- Mary-Caryl Goff
- Janis W Henderson
- Robert S. Henderson
- Steven F Hinchey
- Melissa Ann Hodgson
- Jenifer L Gietek LCSW LLC
All providers in South Glastonbury, CT · Internal Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.