Provider Demographics
NPI:1699008375
Name:GOLDSTONE, ELAINE BROWN (NP)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:BROWN
Last Name:GOLDSTONE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WEST 97TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025
Mailing Address - Country:US
Mailing Address - Phone:212-316-5314
Mailing Address - Fax:212-864-7629
Practice Address - Street 1:110 WEST 97TH STREET
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:212-316-5314
Practice Address - Fax:212-864-7629
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337687363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY331403Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification