Provider Demographics
NPI:1619306784
Name:GOLDSMITH, LEE SELIG (MD)
Entity Type:Individual
Prefix:MR
First Name:LEE
Middle Name:SELIG
Last Name:GOLDSMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:747 THIRD AVENUE
Mailing Address - Street 2:37TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-0070
Mailing Address - Country:US
Mailing Address - Phone:212-421-5500
Mailing Address - Fax:201-363-1133
Practice Address - Street 1:747 THIRD AVENUE
Practice Address - Street 2:37TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-0070
Practice Address - Country:US
Practice Address - Phone:212-421-5500
Practice Address - Fax:201-363-1133
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD093200208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice