Provider Demographics
NPI:1164590949
Name:GOLDENBERG, JOYCE (MD)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:GOLDENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 E 39TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-0104
Mailing Address - Country:US
Mailing Address - Phone:212-447-0300
Mailing Address - Fax:212-957-1954
Practice Address - Street 1:10 E 39TH ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-0104
Practice Address - Country:US
Practice Address - Phone:212-447-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY176407208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
P918470OtherOXFORD
4097389OtherAETNA
NY8123OtherACS HEALTHNET OF NORTHEAS
9519276OtherGHI
4097389OtherAETNA
A62273Medicare UPIN