Provider Demographics
NPI:1558304618
Name:GOLDHILL, VICKI (MD)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:GOLDHILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 EAST 56TH STREET
Mailing Address - Street 2:38H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:646-753-1210
Mailing Address - Fax:
Practice Address - Street 1:245 5TH AVE STE 307
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8728
Practice Address - Country:US
Practice Address - Phone:310-882-0854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192185207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY192185OtherOFFICE OF THE PROFESSIONS REGISTRATION CERTIFICATE
NJ023357DHKMedicare ID - Type Unspecified