MEDICARE: DR. IRA MORRIS 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	207T00000X	Neurological Surgery Physician	25MA07767200	NJ

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	25MA07767200	OTHER	NJ	NJ PROVIDER LICENSE NUMBER

General Provider Information

NPI Number	:	1427088590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IRA MORRIS GOLDSTEIN M.D.

Provider Business Mailing Address
First Line	:	70 PARK ST STE 312
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-2960
Country	:	US
Telephone Number	:	201-342-2550
Fax Number	:	201-342-7171

Provider Business Practice Location Address
First Line	:	70 PARK ST STE 312
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07042-2960
Country	:	US
Telephone Number	:	201-342-2550
Fax Number	:	201-342-7171

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

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	06/10/2025

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