Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 35.095462 | OH |
NPI | 1780764035 |
---|---|
Provider Name | Stuart Goldstein |
First Address | Cincinnati, OH 45229-3039 |
Second Address | Cincinnati, OH 45229-3039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 17/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
133074801 | (05) | TX |
F59877 | (02) |