Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | NY |
NPI | 1205914165 |
---|---|
Provider Name | Dr. Carol Lynn Goldstein |
First Address | New York, NY 10010-3716 |
Second Address | New York, NY 10019-5230 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |