MEDICARE: DR. JAY ALAN 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	207N00000X	Dermatology Physician	39484	MA

General Provider Information

NPI Number	:	1851483762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY ALAN GOLDSTEIN M.D.

Provider Business Mailing Address
First Line	:	526 MAIN ST STE 302
Second Line	:
City	:	ACTON
State	:	MA
Zip	:	01720-3301
Country	:	US
Telephone Number	:	978-371-7010
Fax Number	:	978-371-0522

Provider Business Practice Location Address
First Line	:	67 UNION ST
Second Line	:	SUITE 501
City	:	NATICK
State	:	MA
Zip	:	01760-7700
Country	:	US
Telephone Number	:	508-655-0525
Fax Number	:	508-647-0960

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	06/11/2026

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