Provider Demographics
NPI:1164747184
Name:SG ENDOCRINE PC
Entity Type:Organization
Organization Name:SG ENDOCRINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STANISLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:GOYKHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-360-7250
Mailing Address - Street 1:968 RIVER RD STE 203
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-2237
Mailing Address - Country:US
Mailing Address - Phone:973-771-5199
Mailing Address - Fax:973-387-1488
Practice Address - Street 1:968 RIVER RD STE 203
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-2237
Practice Address - Country:US
Practice Address - Phone:201-224-8328
Practice Address - Fax:973-387-1488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty