MEDICARE: DR. DAVID GOLDSMITH 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
1	2080P0210X	Pediatric Nephrology Physician	103932	NY

General Provider Information

NPI Number	:	1235459967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID GOLDSMITH M.D.

Provider Business Mailing Address
First Line	:	139 E 63RD ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10065-7408
Country	:	US
Telephone Number	:	212-688-7556
Fax Number	:	212-750-0988

Provider Business Practice Location Address
First Line	:	139 E 63RD ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10065-7408
Country	:	US
Telephone Number	:	212-688-7556
Fax Number	:	212-750-0988

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

Provider Enumeration Date	:	06/04/2010
Last Update Date	:	06/04/2010

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