Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 280964 | NY |
NPI | 1477896967 |
---|---|
Provider Name | Dr. Bradley Harris Goldberg |
First Address | Lake Success, NY 11042 |
Second Address | Manhasset, NY 11030-3816 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2013 |
Last Update Date | 02/10/2019 |