Provider Demographics
NPI:1609894641
Name:NAOMI BERRIE DIABETES CENTER
Entity Type:Organization
Organization Name:NAOMI BERRIE DIABETES CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:STEPHANIE
Authorized Official - Last Name:GOLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-851-5494
Mailing Address - Street 1:1150 ST NICHOLAS AVE
Mailing Address - Street 2:2ND FL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3822
Mailing Address - Country:US
Mailing Address - Phone:212-851-5494
Mailing Address - Fax:212-851-5493
Practice Address - Street 1:1150 ST NICHOLAS AVE
Practice Address - Street 2:2ND FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3822
Practice Address - Country:US
Practice Address - Phone:212-851-5494
Practice Address - Fax:212-851-5493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty