MEDICARE: DR. STEVEN JAY 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
1	208000000X	Pediatrics Physician	144545	NY

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

General Provider Information

NPI Number	:	1306929872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN JAY GOLDSTEIN M.D.

Provider Business Mailing Address
First Line	:	31 SUNSET RD S
Second Line	:
City	:	ALBERTSON
State	:	NY
Zip	:	11507-1134
Country	:	US
Telephone Number	:	516-621-0940
Fax Number	:

Provider Business Practice Location Address
First Line	:	14149 70TH RD
Second Line	:
City	:	KEW GARDENS HILLS
State	:	NY
Zip	:	11367-1936
Country	:	US
Telephone Number	:	718-268-5282
Fax Number	:

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	09/23/2020

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