Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 26NJ00045100 | NJ |
NPI | 1609836493 |
---|---|
Provider Name | Mrs. Denise Goldstein |
First Address | New City, NY 10956-6349 |
Second Address | Ridgewood, NJ 07450-2726 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 08/07/2007 |