Provider Demographics
NPI:1609836493
Name:GOLDSTEIN, DENISE (APN)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 LADY GODIVA WAY
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-6349
Mailing Address - Country:US
Mailing Address - Phone:845-634-7608
Mailing Address - Fax:845-323-4105
Practice Address - Street 1:223 N VAN DIEN AVE
Practice Address - Street 2:CARDIOTHORACIC SURGERY OFFICE
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-2726
Practice Address - Country:US
Practice Address - Phone:201-447-8418
Practice Address - Fax:201-447-8658
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00045100363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine