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General NPI Number Information
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NPI Number | 1851473011
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Entity Type | Individual
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Provider Name | CARY GOLDSMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 07/30/2007
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Provider Practice Location Address
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Address Line | 2344 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-6607
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Country | US
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Telephone | 718-494-7546
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Fax | 718-982-1613
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Provider Business Mailing Address
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Address Line | 652 HARRIS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10314-4361
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Country | US
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Telephone | 718-494-7546
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Fax | 718-982-1613
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 157529
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License Number State | NY
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