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General NPI Number Information
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NPI Number | 1821071192
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Entity Type | Individual
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Provider Name | JONATHAN M GOLDSTEIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 12/02/2013
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Provider Practice Location Address
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Address Line | 535 E 70TH ST DEPARTMENT OF NEUROLOGY
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City | NEW YORK
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State | NY
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Zip | 10021-4823
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Country | US
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Telephone | 212-606-1046
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Fax | 212-249-9185
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Provider Business Mailing Address
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Address Line | PO BOX 29234
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City | NEW YORK
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State | NY
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Zip | 10087-9234
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Country | US
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Telephone | 631-329-6925
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Fax | 631-329-6951
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 030692
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 270535
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2084N0008X
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Taxonomy Name | Neuromuscular Medicine (Psychiatry & Neurology) Physician
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License Number | 270535
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License Number State | NY
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