Healthcare Provider Details

I. General information

NPI: 1235160607
Provider Name (Legal Business Name): SUSAN L. GOLDFINE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 11/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 AMSTERDAM AVE
NEW YORK NY
10025
US

IV. Provider business mailing address

1780 BROADWAY 1100
NEW YORK NY
10019
US

V. Phone/Fax

Practice location:
  • Phone: 212-523-4272
  • Fax: 212-523-3798
Mailing address:
  • Phone: 212-590-2930
  • Fax: 212-590-2982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number114422
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2085R0205X
TaxonomyRadiological Physics Physician
License Number114422
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: