MEDICARE: MARCY A GOLDSTEIN 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
1	207N00000X	Dermatology Physician	25MA05994500	NJ
2	174400000X	Specialist	25MA05994500	NJ

General Provider Information

NPI Number	:	1942209028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCY A GOLDSTEIN MD

Provider Business Mailing Address
First Line	:	1 W RIDGEWOOD AVE
Second Line	:	SUITE # 305
City	:	PARAMUS
State	:	NJ
Zip	:	07652-2359
Country	:	US
Telephone Number	:	201-445-8786
Fax Number	:	201-445-8811

Provider Business Practice Location Address
First Line	:	1 W RIDGEWOOD AVE
Second Line	:	SUITE # 305
City	:	PARAMUS
State	:	NJ
Zip	:	07652-2359
Country	:	US
Telephone Number	:	201-445-8786
Fax Number	:	201-445-8811

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	08/25/2025

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