Provider Demographics
NPI:1245596741
Name:GOLDSTEIN, ELISABETH RACHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:RACHEL
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELISABETH
Other - Middle Name:RACHEL
Other - Last Name:LEVENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 ARDSLEY CT
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2956
Mailing Address - Country:US
Mailing Address - Phone:862-205-9506
Mailing Address - Fax:
Practice Address - Street 1:2 ARDSLEY CT
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:NJ
Practice Address - Zip Code:07869-2956
Practice Address - Country:US
Practice Address - Phone:862-205-9506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA10058700207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program