Basic Information
| Provider Information | |||||||||
| NPI: | 1154351112 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOLDHAHN | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | THOMAS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 OLD YORK ROAD | ||||||||
| Address2: | ABINGTON MEMORIAL HOSPITAL | ||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190013788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154812367 | ||||||||
| FaxNumber: | 2154814481 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 OLD YORK RD | ||||||||
| Address2: | |||||||||
| City: | ABINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190013720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2154812367 | ||||||||
| FaxNumber: | 2154814481 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZD0900X | MD008253E | PA | X | Allopathic & Osteopathic Physicians | Pathology | Dermatopathology | 207ZP0102X | MD008253E | PA | X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 008211 | 05 | PA | MEDICAID |