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NPI 1790896785

NPI 1790896785 : GARY H GOLDMAN MD : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1790896785
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    Entity Type          |    Individual 
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    Provider Name        |    GARY H GOLDMAN MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/31/2006
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    Last Update Date     |    11/18/2019
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Provider Practice Location Address
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    Address Line         |    1735 YORK AVE STE A 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10128-6855
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    Country              |    US
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    Telephone            |    212-535-6100
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    Fax                  |    212-535-3956
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Provider Business Mailing Address
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    Address Line         |    1735 YORK AVE STE A 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10128-6855
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    Country              |    US
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    Telephone            |    212-535-6100
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    Fax                  |    212-535-3956
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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        |    207V00000X
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    Taxonomy Name        |    Obstetrics & Gynecology Physician
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    License Number       |    177375
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    License Number State |    NY
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