Provider Demographics
NPI:1336495357
Name:MATTHEW E GOLDSCHMIDT DC PC
Entity Type:Organization
Organization Name:MATTHEW E GOLDSCHMIDT DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOLDSCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:516-623-3940
Mailing Address - Street 1:1955 MERRICK RD
Mailing Address - Street 2:STE. 105
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-4642
Mailing Address - Country:US
Mailing Address - Phone:516-623-3940
Mailing Address - Fax:
Practice Address - Street 1:1955 MERRICK RD
Practice Address - Street 2:STE. 105
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-4642
Practice Address - Country:US
Practice Address - Phone:516-623-3940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011888111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty