Provider Demographics
NPI:1699858852
Name:GOLDSTEIN, BARRY I (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:I
Last Name:GOLDSTEIN
Suffix:
Gender:M
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:PALMA DRIVE
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528
Mailing Address - Country:US
Mailing Address - Phone:914-835-2421
Mailing Address - Fax:
Practice Address - Street 1:150 LOCKWOOD AVENUE
Practice Address - Street 2:SUITE 30
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801
Practice Address - Country:US
Practice Address - Phone:914-636-2611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120339207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
17A941Medicare ID - Type Unspecified
C06218Medicare UPIN