Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 242723 | NY |
NPI | 1023213873 |
---|---|
Provider Name | Valerie Goldburt |
First Address | New Hyde Park, NY 11040 |
Second Address | Fresh Meadows, NY 11365 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2007 |
Last Update Date | 17/04/2008 |