1619953908 NPI number — DR. HAROLD L GOLDSTEIN DPM

Table of content: DR. HAROLD L GOLDSTEIN DPM (NPI 1619953908)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619953908 NPI number — DR. HAROLD L GOLDSTEIN DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOLDSTEIN
Provider First Name:
HAROLD
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1619953908
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
210 WESTCHESTER AVE
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10604-2901
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-681-3146
Provider Business Mailing Address Fax Number:
914-682-6403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
210 WESTCHESTER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10604-2901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-633-0650
Provider Business Practice Location Address Fax Number:
914-682-6403
Provider Enumeration Date:
12/19/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0131X , with the licence number:  N004891 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 489100 . This is a "CONNECTICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6200456 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: PO5821 . This is a "BLUE CROSS PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000037672 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1C8473 . This is a "HEALTH NET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2103259 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1385119 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P610083 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01287407050 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 133884168 . This is a "EMPIRE STATE PLAN (NYS)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "POMCO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6396580006 . This is a "CIGNA PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "BEECH STREET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "MULTIPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 480034408 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: N004891 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5051510 . This is a "AETNA NON HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 509436 . This is a "PHCS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".