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NPI Code Detail

MEDICARE: DR. ROY JEFFREY GOLDBERG MD

MEDICARE: DR. ROY JEFFREY 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
1207RG0300XGeriatric Medicine (Internal Medicine) Physician156644NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962514034
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROY JEFFREY GOLDBERG MD
Provider Business Mailing Address
First Line : POB 483
Second Line :
City : PATTERSON
State : NY
Zip : 12563
Country : US
Telephone Number : 914-262-4141
Fax Number : 718-405-3501
Provider Business Practice Location Address
First Line : 2000 E GUN HILL RD
Second Line :
City : BRONX
State : NY
Zip : 10469-6016
Country : US
Telephone Number : 718-405-3535
Fax Number : 718-405-3501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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