Healthcare Provider Details

I. General information

NPI: 1134199433
Provider Name (Legal Business Name): LAWRENCE S GOLDSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 WINDHAM CT SUITE 1
BOARDMAN OH
44512-5087
US

IV. Provider business mailing address

6780 MAYFIELD RD STE 323
MAYFIELD HEIGHTS OH
44124-2203
US

V. Phone/Fax

Practice location:
  • Phone: 330-726-3357
  • Fax: 330-726-1465
Mailing address:
  • Phone: 440-312-7140
  • Fax: 440-312-7142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number35063779
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number35063779
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: