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General NPI Number Information
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NPI Number | 1033416110
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Entity Type | Organization
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Legal Business Name | HENRY R GOLDSTEIN MD PC
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Dates
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Enumeration Date | 02/25/2011
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Last Update Date | 05/05/2011
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Provider Practice Location Address
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Address Line | 123 PIKE ST
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City | PORT JERVIS
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State | NY
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Zip | 12771-1824
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Country | US
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Telephone | 845-856-6609
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Fax |
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Provider Business Mailing Address
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Address Line | 123 PIKE STREET
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City | PORT JERVIS
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State | NY
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Zip | 12771-1824
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HENRY RICHARD GOLDSTEIN
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Credential | M.D,
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Telephone | 845-856-6609
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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