Provider Demographics
NPI:1639118946
Name:GOLDIN, FRIDA (MD)
Entity Type:Individual
Prefix:DR
First Name:FRIDA
Middle Name:
Last Name:GOLDIN
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 1:2269 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229
Mailing Address - Country:US
Mailing Address - Phone:718-339-8200
Mailing Address - Fax:718-336-0069
Practice Address - Street 1:2269 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:718-339-8200
Practice Address - Fax:718-336-0069
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166469208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00962634Medicaid
A64126Medicare UPIN
NY75D101Medicare ID - Type Unspecified