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NPI Code Detail

MEDICARE: BARRY GOLDBERG MD

MEDICARE: BARRY GOLDBERG MD
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
12085R0202XDiagnostic Radiology Physician220617NY

General Provider Information

NPI Number : 1871583989
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARRY GOLDBERG MD
Provider Business Mailing Address
First Line : PO BOX 130
Second Line :
City : LATHAM
State : NY
Zip : 12110-0130
Country : US
Telephone Number : 518-786-1291
Fax Number : 518-786-1293
Provider Business Practice Location Address
First Line : 211 CHURCH ST
Second Line :
City : SARATOGA SPGS
State : NY
Zip : 12866-1046
Country : US
Telephone Number : 518-583-8461
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2005
Last Update Date : 07/08/2007

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Directions to “ BARRY GOLDBERG MD” Practice Location

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