Provider Demographics
NPI:1962434464
Name:GOTSDINER, DENISE BETH (MD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:BETH
Last Name:GOTSDINER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:504 CYNWYD CIR
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2507
Mailing Address - Country:US
Mailing Address - Phone:610-664-0505
Mailing Address - Fax:215-481-2366
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-481-2366
Practice Address - Fax:215-481-4481
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD049775L207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG00313Medicare UPIN
PA633393Medicare ID - Type Unspecified