Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 25MA10796000 | NJ |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 278966 | NY |
N | 207RC0000X | Internist - Cardiovascular Disease | 278966 | NY |
NPI | 1063775419 |
---|---|
Provider Name | Randal Ian Goldberg |
First Address | New York, NY 10016-6402 |
Second Address | New York, NY 10016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2012 |
Last Update Date | 02/09/2021 |