Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F301204-1 | NY |
NPI | 1013087220 |
---|---|
Provider Name | Bonnie Goldstein |
First Address | Pittsford, NY 14534-3962 |
Second Address | Rochester, NY 14620-4629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |