Provider Demographics
NPI:1326044678
Name:GOLDSMITH, PETER M (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:M
Last Name:GOLDSMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E 17TH ST
Mailing Address - Street 2:APT. 21C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3607
Mailing Address - Country:US
Mailing Address - Phone:212-475-7758
Mailing Address - Fax:
Practice Address - Street 1:201 E 17TH ST
Practice Address - Street 2:APT. 21C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3607
Practice Address - Country:US
Practice Address - Phone:212-475-7758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1861642085R0202X
NJ25MA050310002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology