Provider Demographics
NPI:1659338838
Name:GOLDSTEIN, ERIKA SARAH (ARNP)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:SARAH
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 VT ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:NEWFANE
Mailing Address - State:VT
Mailing Address - Zip Code:05345-9656
Mailing Address - Country:US
Mailing Address - Phone:802-365-7603
Mailing Address - Fax:
Practice Address - Street 1:677 COURT ST
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1702
Practice Address - Country:US
Practice Address - Phone:603-357-3800
Practice Address - Fax:603-355-8922
Is Sole Proprietor?:No
Enumeration Date:2006-04-30
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH054600-23-03207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30343778Medicaid
AA45404OtherHARVARD PILGRIM
NH23YP08695NH01OtherANTHEM
NH23YP08695NH01OtherANTHEM
NHNP5142Medicare PIN