Provider Demographics
NPI:1902021843
Name:GOLDBERG, WARREN ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:ALAN
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:144 COUNTRY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6626
Mailing Address - Country:US
Mailing Address - Phone:212-988-1303
Mailing Address - Fax:212-628-9113
Practice Address - Street 1:1440 YORK AVE
Practice Address - Street 2:SUITE P-1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2577
Practice Address - Country:US
Practice Address - Phone:212-988-1303
Practice Address - Fax:212-628-9113
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60-1658472085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology