Provider Demographics
NPI:1083685382
Name:GOLDSTEIN, ADAM M (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:M
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 LIBERTY SQ
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-2636
Mailing Address - Country:US
Mailing Address - Phone:860-827-1343
Mailing Address - Fax:860-827-1812
Practice Address - Street 1:1 LIBERTY SQ
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-2636
Practice Address - Country:US
Practice Address - Phone:860-827-1343
Practice Address - Fax:860-827-1812
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT039348207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1393488Medicaid
H34675Medicare UPIN