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1134172349

NPI Code Detail

MEDICARE: JONATHAN S GOLDBERG MD

MEDICARE: JONATHAN S GOLDBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	201960	NY
2	207RH0003X	Hematology & Oncology Physician	201960	NY
3	207RX0202X	Medical Oncology Physician	201960	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00232099	OTHER	NY	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0667910001	OTHER	NY	DME

General Provider Information

NPI Number	:	1134172349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN S GOLDBERG MD

Provider Business Mailing Address
First Line	:	110 S BEDFORD RD
Second Line	:	CAREMOUNT MEDICAL PC
City	:	MOUNT KISCO
State	:	NY
Zip	:	10549-3446
Country	:	US
Telephone Number	:	914-241-1050
Fax Number	:	914-242-1516

Provider Business Practice Location Address
First Line	:	185 ROUTE 312
Second Line	:
City	:	BREWSTER
State	:	NY
Zip	:	10509-2337
Country	:	US
Telephone Number	:	845-231-5600
Fax Number	:	845-231-5489

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	11/17/2016

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Directions to “ JONATHAN S GOLDBERG MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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