Provider Demographics
NPI:1790725661
Name:GOLDSTEIN, ASHER C (MD)
Entity Type:Individual
Prefix:MR
First Name:ASHER
Middle Name:C
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 1:160 OVERLOOK AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2285
Mailing Address - Country:US
Mailing Address - Phone:201-645-4336
Mailing Address - Fax:
Practice Address - Street 1:160 OVERLOOK AVE STE 1A
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2285
Practice Address - Country:US
Practice Address - Phone:201-645-4336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229572208100000X
NJ25MA082685002081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
33P831Medicare ID - Type Unspecified
MR33P831Medicare ID - Type Unspecified
I36460Medicare UPIN