Provider Demographics
NPI:1225079734
Name:NEAL D. GOLDBERG, MD PC
Entity Type:Organization
Organization Name:NEAL D. GOLDBERG, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:D
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-722-6980
Mailing Address - Street 1:495 CENTRAL PARK AVE
Mailing Address - Street 2:SUITE 305 B
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1068
Mailing Address - Country:US
Mailing Address - Phone:914-722-6980
Mailing Address - Fax:914-470-5056
Practice Address - Street 1:495 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 305 B
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1068
Practice Address - Country:US
Practice Address - Phone:914-722-6980
Practice Address - Fax:914-470-5056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224305208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWHW421Medicare PIN