Provider Demographics
NPI:1114668167
Name:GOLDSTEIN, DANIEL M
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 KESSLER FARM DR APT 588
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03063-7145
Mailing Address - Country:US
Mailing Address - Phone:914-980-5590
Mailing Address - Fax:
Practice Address - Street 1:71 ELM ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:NH
Practice Address - Zip Code:03055-4810
Practice Address - Country:US
Practice Address - Phone:603-673-2907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMOT-2024-0038225X00000X
NH457925225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist