Provider Demographics
NPI:1821240672
Name:GOLDSTEIN, LAWRENCE J (RPH)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:J
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 EDGEMERE ST
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-3402
Mailing Address - Country:US
Mailing Address - Phone:914-738-7870
Mailing Address - Fax:
Practice Address - Street 1:2226 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-9404
Practice Address - Country:US
Practice Address - Phone:718-547-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
5804782OtherNABP NUMBER
NYFW3140946OtherDEA NUMBER