Provider Demographics
NPI:1760435846
Name:GOLDSTEIN, BARRY (DC)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 BROADWAY RM 606
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-5020
Mailing Address - Country:US
Mailing Address - Phone:212-247-4330
Mailing Address - Fax:
Practice Address - Street 1:1410 BROADWAY RM 610
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-5007
Practice Address - Country:US
Practice Address - Phone:212-247-4330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX003914-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX23551Medicare ID - Type Unspecified