Provider Demographics
NPI:1255471017
Name:GOLDMAN, AMY BETH (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY BETH
Middle Name:
Last Name:GOLDMAN
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 1:333 E 79TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-0956
Mailing Address - Country:US
Mailing Address - Phone:212-734-1713
Mailing Address - Fax:212-288-2620
Practice Address - Street 1:333 E 79TH ST
Practice Address - Street 2:(PH-Y)
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-0956
Practice Address - Country:US
Practice Address - Phone:212-734-1713
Practice Address - Fax:212-288-2620
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1094492085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology