Provider Demographics
NPI:1710224845
Name:GOLDSMITH, VINOD K (PT)
Entity Type:Individual
Prefix:
First Name:VINOD
Middle Name:K
Last Name:GOLDSMITH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1656 E 12TH ST
Mailing Address - Street 2:2 FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1012
Mailing Address - Country:US
Mailing Address - Phone:718-998-3020
Mailing Address - Fax:718-998-9059
Practice Address - Street 1:130 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3821
Practice Address - Country:US
Practice Address - Phone:845-799-2165
Practice Address - Fax:845-499-2166
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY034228OtherLICENSE