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GOLDSTEIN, JACK

Debarred entity

GOLDSTEIN, JACK is a person of interest. They have not been found on international sanctions lists.

Type	Person				[sources]
Name	GOLDSTEIN, JACK · Jack Goldstein				[sources]
Birth date	not available				[sources]
Nationality	not available				[sources]
Country	United States				[sources]
First name	Jack				[sources]
ID Number	`OS002324L (PA)`				[sources]
Last name	Goldstein				[sources]
NPI	`1154355055`				[sources]
Sector	DO				[sources]
Title	DO				[sources]
Address	(NJ), (NJ) · 695A MAIN STREET, LUMBERTON, NJ 08048				[sources]
Last change	2024-11-29	Last processed	2025-10-15	First seen	2024-10-01

Sanctions
Country	Authority	Program	Start date	End date
United States	New Jersey Office of the State Comptroller		2015-11-20	-

Address
Full address	Country
695A MAIN STREET, LUMBERTON, NJ 08048	United States

Medical providers who are precluded from participation in the Medical Assistance Program

United States of America · DHS

Medical providers disqualified from participating in New Jersey State's Medicaid program.

United States of America · OIFP

Source data IDs: us-mednj-faf09d970ae8ec43aed3c5d195c1c0bbe04c9a80 · us-medpa-fdc539d4d96e1fab011243809702815c04fc9f98

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