Provider Demographics
NPI:1285662908
Name:GOLDSTEIN, AMY (DO)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 DUTCH HILL RD
Mailing Address - Street 2:SUITE 18
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-1723
Mailing Address - Country:US
Mailing Address - Phone:845-359-4770
Mailing Address - Fax:845-359-0017
Practice Address - Street 1:60 DUTCH HILL RD
Practice Address - Street 2:SUITE 18
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-1723
Practice Address - Country:US
Practice Address - Phone:845-359-4770
Practice Address - Fax:845-359-0017
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207403174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG56435Medicare UPIN