MEDICARE: DR. CAROL LYNN GOLDSTEIN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NN1001X	Nutrition Chiropractor		NY

General Provider Information

NPI Number	:	1205914165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROL LYNN GOLDSTEIN DC

Provider Business Mailing Address
First Line	:	330 3RD AVE APT 10G
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-3716
Country	:	US
Telephone Number	:	212-213-2032
Fax Number	:	212-489-9396

Provider Business Practice Location Address
First Line	:	850 7TH AVE
Second Line	:	SUITE 602
City	:	NEW YORK
State	:	NY
Zip	:	10019-5230
Country	:	US
Telephone Number	:	212-489-9396
Fax Number	:	212-489-8164

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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