Provider Demographics
NPI:1487273751
Name:GOLDMAN, LYNN ROSE (MD)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:ROSE
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 NEW HAMPSHIRE AVE NW FL 7
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2301
Mailing Address - Country:US
Mailing Address - Phone:202-994-5179
Mailing Address - Fax:
Practice Address - Street 1:950 NEW HAMPSHIRE AVE NW FL 7
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2301
Practice Address - Country:US
Practice Address - Phone:202-994-5179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG483412083P0901X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine