Provider Demographics
NPI:1083218515
Name:GOLDSTEIN, SHIRAH
Entity Type:Individual
Prefix:MRS
First Name:SHIRAH
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:SHIRAH
Other - Middle Name:
Other - Last Name:GOLDSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12 PARKER BLVD
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1431
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 PARKER BLVD
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1431
Practice Address - Country:US
Practice Address - Phone:845-641-3851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-25
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant