Healthcare Provider Details

I. General information

NPI: 1851483762
Provider Name (Legal Business Name): JAY ALAN GOLDSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 UNION ST SUITE 501
NATICK MA
01760-7700
US

IV. Provider business mailing address

526 MAIN ST STE 302
ACTON MA
01720-3301
US

V. Phone/Fax

Practice location:
  • Phone: 508-655-0525
  • Fax: 508-647-0960
Mailing address:
  • Phone: 978-371-7010
  • Fax: 978-371-0522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number39484
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: