Basic Information
| Provider Information | |||||||||
| NPI: | 1053353987 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLDHAMMER | ||||||||
| FirstName: | ELAINE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 565 COAL VALLEY RD | ||||||||
| Address2: | |||||||||
| City: | JEFFERSON HILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150253703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122676810 | ||||||||
| FaxNumber: | 4122676817 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 MEDICAL BLVD | ||||||||
| Address2: | |||||||||
| City: | CANONSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153179762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123593030 | ||||||||
| FaxNumber: | 4123593060 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2006 | ||||||||
| LastUpdateDate: | 06/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N3051 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | N3051 | TX | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 25MA07992200 | NJ | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | MD444320 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 204494302 | 05 | TX | MEDICAID | 204494301 | 05 | TX | MEDICAID |