Provider Demographics
NPI:1174680581
Name:GOLDIN, FERISH Y (MD)
Entity Type:Individual
Prefix:
First Name:FERISH
Middle Name:Y
Last Name:GOLDIN
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 1:14 BEECHER TER
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02459-2319
Mailing Address - Country:US
Mailing Address - Phone:617-783-5783
Mailing Address - Fax:
Practice Address - Street 1:ALLSTON PHYSICAL MEDICAL
Practice Address - Street 2:39 BRIGHTON AVENUE
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134
Practice Address - Country:US
Practice Address - Phone:617-783-5783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA52370208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice