Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 001999 | NY |
NPI | 1164057030 |
---|---|
Provider Name | Sarah Goltzman |
First Address | Atlanta, GA 30306-2340 |
Second Address | Webster, NY 14580-1957 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2020 |
Last Update Date | 04/05/2020 |