Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 168563 | NY |
NPI | 1326128885 |
---|---|
Provider Name | Gary L Goldberg |
First Address | New Rochelle, NY 10804-3317 |
Second Address | Bronx, NY 10461 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/07/2007 |