Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 286616 | NY |
NPI | 1164765038 |
---|---|
Provider Name | Dr. Karli Provost Goldstein |
First Address | New York, NY 10065-4901 |
Second Address | New York, NY 10065-4901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2013 |
Last Update Date | 01/07/2020 |