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Jacob B. Goldstein, PM, LLC HIPAA Statement Notice of Privacy Practices AUTHORIZATION FOR RELEASE OF PROTECTED HEALTH INFORMATION I hereby give my consent for Dr. Jacob B. Goldstein, PM, LLC (The

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Individuals who are seeking podiatric care from Dr. Jacob B Goldstein, a Doctor of Podiatric Medicine (DPM).

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What is jacob b goldstein dpm?

Jacob B. Goldstein DPM is a podiatrist.

Who is required to file jacob b goldstein dpm?

Podiatrists are required to file Jacob B. Goldstein DPM.

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Jacob B. Goldstein DPM can be filled out online or in paper form.

What is the purpose of Jacob B. Goldstein DPM?

The purpose of Jacob B. Goldstein DPM is to report podiatry services and procedures.

What information must be reported on Jacob B. Goldstein DPM?

Information such as patient demographics, diagnosis, treatment provided, and charges must be reported on Jacob B. Goldstein DPM.

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