Healthcare Provider Details

I. General information

NPI: 1558475376
Provider Name (Legal Business Name): ROBERT DAVID GOLDSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 02/23/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 HUTCHINSON RIVER PKWY STE 793
BRONX NY
10465-1882
US

IV. Provider business mailing address

815 HUTCHINSON RIVER PKWY STE 793
BRONX NY
10465-1882
US

V. Phone/Fax

Practice location:
  • Phone: 718-792-4700
  • Fax: 718-792-1255
Mailing address:
  • Phone: 718-792-4700
  • Fax: 718-792-1255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number135127
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: