| 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 | Last processed | First seen | |||
Medical providers who are precluded from participation in the Medical Assistance Program
United States · DHS
Medical providers disqualified from participating in New Jersey State's Medicaid program.
United States · OIFP
us-mednj-faf09d970ae8ec43aed3c5d195c1c0bbe04c9a80 · us-medpa-fdc539d4d96e1fab011243809702815c04fc9f98For experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States | New Jersey Office of the State Comptroller | - | |||
| Address | ||
|---|---|---|
| Full address | Country | |
| (NJ), (NJ) · NJ, NJ | United States | |
| United States | Department of Human Services | - | - |
| United States | New Jersey Office of the State Comptroller | - | - |
| United States |