Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | MA54218 | NJ |
NPI | 1396724704 |
---|---|
Provider Name | Dr. Joel M Goldstein |
First Address | Manasquan, NJ 08736 |
Second Address | Manasquan, NJ 08736 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2006 |
Last Update Date | 26/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E55730 | (02) | NJ |