Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 25MB10444000 | NJ |
NPI | 1013321769 |
---|---|
Provider Name | Dr. Daniel Goltz |
First Address | Brooklyn, NY 11235-7791 |
Second Address | Brooklyn, NY 11235-7791 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2014 |
Last Update Date | 15/11/2018 |