Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 159310 | NY |
NPI | 1003992991 |
---|---|
Provider Name | Dr. Jeffrey Brian Goldstein |
First Address | Harrison, NY 10528-1634 |
Second Address | Harrison, NY 10528-1635 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 10/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A5999 | (02) | NY |