Provider Demographics
NPI:1336131432
Name:GOLDSMITH, ERIC DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:DAVID
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 1:420 MADISON AVE
Mailing Address - Street 2:SUITE 801
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1107
Mailing Address - Country:US
Mailing Address - Phone:212-486-2754
Mailing Address - Fax:212-486-2758
Practice Address - Street 1:420 MADISON AVE
Practice Address - Street 2:SUITE 801
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1107
Practice Address - Country:US
Practice Address - Phone:212-486-2754
Practice Address - Fax:212-486-2758
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2009-01-07
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-04-10
Provider Licenses
StateLicense IDTaxonomies
NY1769732084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY21I702Medicare PIN
NYF37947Medicare UPIN