| Goldson Medical Associates, Llc | |
|
20 Valley St Suite 320 South Orange NJ 07079-2887 | |
| (973) 313-1113 | |
| (973) 313-1191 |
| Full Name | Goldson Medical Associates, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 20 Valley St, South Orange, New Jersey |
| Authorized Official Name and Position | Debra Natalia Goldson-prophete (OWNER) |
| Authorized Official Contact | 9733131113 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Goldson Medical Associates, Llc Po Box A West Orange NJ 07052-0200 Ph: (973) 313-1113 | Goldson Medical Associates, Llc 20 Valley St Suite 320 South Orange NJ 07079-2887 Ph: (973) 313-1113 |
| NPI Number | 1184668485 |
|---|---|
| Provider Enumeration Date | 06/16/2006 |
| Last Update Date | 11/29/2023 |
| Medicare PECOS PAC ID | 2668484254 |
|---|---|
| Medicare Enrollment ID | O20060623000088 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184668485 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Debra N Goldson-prophete |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831156819 PECOS PAC ID: 3577575166 Enrollment ID: I20060623000083 |
| Provider Name | Deepa Rajiv |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891808390 PECOS PAC ID: 0840296190 Enrollment ID: I20090624000167 |
| Provider Name | Samantha R Minott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063980688 PECOS PAC ID: 7012253487 Enrollment ID: I20190107002980 |
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