Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 52731 | CT |
NPI | 1164579181 |
---|---|
Provider Name | Lee J Goldstein |
First Address | Easton, CT 06612-1660 |
Second Address | Stratford, CT 06614-1514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 10/01/2020 |