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NPI Code Detail

MEDICARE: GOLDMAN DERMATOLOGY, PLLC

MEDICARE: GOLDMAN DERMATOLOGY, PLLC
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
1174400000XSpecialist188106-1NY

General Provider Information

NPI Number : 1154311900
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOLDMAN DERMATOLOGY, PLLC
Provider Business Mailing Address
First Line : 150 BROADWAY
Second Line : SUITE 1110
City : NEW YORK
State : NY
Zip : 10038-4381
Country : US
Telephone Number : 212-962-1115
Fax Number : 212-962-1246
Provider Business Practice Location Address
First Line : 150 BROADWAY
Second Line : SUITE 1110
City : NEW YORK
State : NY
Zip : 10038-4381
Country : US
Telephone Number : 212-962-1115
Fax Number : 212-962-1246
Authorized Official
Title or Position : OWNER
Name : DR. BARRY D GOLDMAN
Credential : M.D.
Telephone Number : 212-962-1115
Provider Enumeration Date : 10/24/2005
Last Update Date : 05/06/2008

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Directions to “GOLDMAN DERMATOLOGY, PLLC ” Practice Location

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