Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 135098 | NY |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 135098 | NY |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 135098 | NY |
N | 2081P2900X | Pain Medicine | 135098 | NY |
N | 2081S0010X | Sports Medicine | 135098 | NY |
N | 213ES0000X | Sports Medicine | 135098 | NY |
NPI | 1558344309 |
---|---|
Provider Name | Dr. Robert B Goldberg |
First Address | New York, NY 10014-5002 |
Second Address | New York, NY 10014-5002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2005 |
Last Update Date | 23/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B77735 | (02) | NY |