Provider Demographics
NPI:1619290491
Name:ARTHUR I. GOLDBERG M.D. P.C.
Entity Type:Organization
Organization Name:ARTHUR I. GOLDBERG M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:I
Authorized Official - Last Name:GOLDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACP
Authorized Official - Phone:212-249-0030
Mailing Address - Street 1:945 5TH AVE OFC 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2667
Mailing Address - Country:US
Mailing Address - Phone:212-249-0030
Mailing Address - Fax:212-744-2413
Practice Address - Street 1:945 5TH AVE OFC 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2667
Practice Address - Country:US
Practice Address - Phone:212-249-0030
Practice Address - Fax:212-744-2413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY107855174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNS3165OtherOXFORD
NYAG09710010Medicare PIN
NYB80197Medicare UPIN
NY971001Medicare PIN