Provider Demographics
NPI:1144481391
Name:GOLDMAN, MAURICE EDWARD (MD)
Entity type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:EDWARD
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3306 LATHAM CT
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-6011
Mailing Address - Country:US
Mailing Address - Phone:973-369-7651
Mailing Address - Fax:
Practice Address - Street 1:3306 LATHAM CT
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-6011
Practice Address - Country:US
Practice Address - Phone:973-369-7651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02796800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine