Provider Demographics
NPI:1871864884
Name:DR STEVEN B GOLDSTEIN DC PC
Entity Type:Organization
Organization Name:DR STEVEN B GOLDSTEIN DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:B
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-887-1001
Mailing Address - Street 1:215 ATLANTIC AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3567
Mailing Address - Country:US
Mailing Address - Phone:516-887-1001
Mailing Address - Fax:516-887-1004
Practice Address - Street 1:215 ATLANTIC AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-3567
Practice Address - Country:US
Practice Address - Phone:516-887-1001
Practice Address - Fax:516-887-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-23
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3915111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX21451Medicare PIN