Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 110937 | NY |
NPI | 1023154887 |
---|---|
Provider Name | Dr. Seth I Goldberg |
First Address | Manhasset, NY 11030-2932 |
Second Address | Manhasset, NY 11030-2932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 08/07/2007 |