Healthcare Provider Details

I. General information

NPI: 1942209028
Provider Name (Legal Business Name): MARCY A GOLDSTEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 W RIDGEWOOD AVE SUITE # 305
PARAMUS NJ
07652-2359
US

IV. Provider business mailing address

1 W RIDGEWOOD AVE SUITE # 305
PARAMUS NJ
07652-2359
US

V. Phone/Fax

Practice location:
  • Phone: 201-445-8786
  • Fax: 201-445-8811
Mailing address:
  • Phone: 201-445-8786
  • Fax: 201-445-8811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number25MA05994500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MA05994500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: