Provider Demographics
NPI:1053353987
Name:GOLDHAMMER, ELAINE L (MD)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:L
Last Name:GOLDHAMMER
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 1:565 COAL VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3703
Mailing Address - Country:US
Mailing Address - Phone:412-267-6810
Mailing Address - Fax:412-267-6817
Practice Address - Street 1:169 MARTIN AVE
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1734
Practice Address - Country:US
Practice Address - Phone:717-721-4740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3051207R00000X, 208M00000X
PAMD444320207R00000X, 208M00000X
NJ25MA07992200208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX204494301Medicaid
TX204494302Medicaid
TX204494301Medicaid
TX8L17258Medicare PIN
NJG74012Medicare UPIN
TXP00776717Medicare PIN
5E488Medicare ID - Type Unspecified
TX8L17152Medicare PIN