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General NPI Number Information
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NPI Number | 1134198500
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Entity Type | Individual
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Provider Name | JUDY GOLDSTEIN M.D
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Gender | Female
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 03/19/2020
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Provider Practice Location Address
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Address Line | 115 E 57TH ST STE 1450
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City | NEW YORK
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State | NY
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Zip | 10022-2109
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Country | US
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Telephone | 646-727-7373
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Fax |
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Provider Business Mailing Address
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Address Line | 1365 YORK AVE APT 7K
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City | NEW YORK
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State | NY
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Zip | 10021-0432
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Country | US
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Telephone | 917-881-6166
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 118388
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License Number State | NY
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