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General NPI Number Information
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NPI Number | 1871581827
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Entity Type | Individual
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Provider Name | BRUCE I GOLDMAN MD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 601 ELMWOOD AVE BOX 626 URMC
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City | ROCHESTER
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State | NY
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Zip | 14642-0001
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Country | US
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Telephone | 585-273-3401
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Fax | 585-273-3637
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Provider Business Mailing Address
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Address Line | 601 ELMWOOD AVE BOX 626 URMC
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City | ROCHESTER
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State | NY
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Zip | 14642-0001
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Country | US
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Telephone | 585-273-3401
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Fax | 585-273-3637
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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 | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | MD 038843E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 149875
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License Number State | NY
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