Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 273961 | NY |
NPI | 1174899959 |
---|---|
Provider Name | Dr. Jacqueline Gofshteyn |
First Address | Manhasset, NY 11030-3816 |
Second Address | Manhasset, NY 11030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2012 |
Last Update Date | 26/06/2019 |