Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 049437 | NY |
NPI | 1184995276 |
---|---|
Provider Name | Dr. Edward Benjamin Goldin |
First Address | New York, NY 10165-0006 |
Second Address | New York, NY 10165-0006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2012 |
Last Update Date | 20/01/2012 |