Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 202109 | NY |
NPI | 1124172861 |
---|---|
Provider Name | Robert T Goldman |
First Address | Mount Kisco, NY 10549 |
Second Address | Ossining, NY 10562-6301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 14/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02252037 | (05) | NY |
P01212360 | RAILROAD MEDICARE (01) | NY |