Provider Demographics
NPI:1124199658
Name:GOLDMAN, RON G (MD)
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:G
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:185 FAIR ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-4501
Mailing Address - Country:US
Mailing Address - Phone:845-340-0640
Mailing Address - Fax:845-876-2126
Practice Address - Street 1:ULSTER COUNTY MENTAL HEALTH DEPARTMENT
Practice Address - Street 2:239 GOLDEN HILL LANE
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401
Practice Address - Country:US
Practice Address - Phone:845-340-4000
Practice Address - Fax:845-340-4070
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1726802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E44887Medicare UPIN
47F871Medicare ID - Type Unspecified