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NPI Code Detail

MEDICARE: MRS. JUDY GOLDSTEIN M.D

MEDICARE: MRS. JUDY GOLDSTEIN M.D
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
1208000000XPediatrics Physician118388NY

General Provider Information

NPI Number : 1134198500
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JUDY GOLDSTEIN M.D
Provider Business Mailing Address
First Line : 1365 YORK AVE APT 7K
Second Line :
City : NEW YORK
State : NY
Zip : 10021-0432
Country : US
Telephone Number : 917-881-6166
Fax Number :
Provider Business Practice Location Address
First Line : 115 E 57TH ST STE 1450
Second Line :
City : NEW YORK
State : NY
Zip : 10022-2109
Country : US
Telephone Number : 646-727-7373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 03/19/2020

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