Provider Demographics
NPI:1083722987
Name:GOLDBERG & MATHEW MEDICAL ASSOCIATES, P.L.L.C.
Entity Type:Organization
Organization Name:GOLDBERG & MATHEW MEDICAL ASSOCIATES, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:845-634-2727
Mailing Address - Street 1:10 ESQUIRE RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3336
Mailing Address - Country:US
Mailing Address - Phone:845-634-2727
Mailing Address - Fax:845-634-2882
Practice Address - Street 1:10 ESQUIRE RD
Practice Address - Street 2:SUITE 6
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3336
Practice Address - Country:US
Practice Address - Phone:845-634-2727
Practice Address - Fax:845-634-2882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2012-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWER091Medicare PIN
NYDB5559Medicare PIN