Provider Demographics
NPI:1386031219
Name:ROBERT GOLDSTEIN, M.D., PS
Entity Type:Organization
Organization Name:ROBERT GOLDSTEIN, M.D., PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOYT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-946-9375
Mailing Address - Street 1:6703 W RIO GRANDE AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-2623
Mailing Address - Country:US
Mailing Address - Phone:509-946-9375
Mailing Address - Fax:509-736-1503
Practice Address - Street 1:6703 W RIO GRANDE AVE BLDG A
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-2623
Practice Address - Country:US
Practice Address - Phone:509-946-9375
Practice Address - Fax:509-763-1503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00039823207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty