Provider Demographics
NPI:1952453581
Name:GOLDSTEIN, JAMEE MICHELE (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMEE
Middle Name:MICHELE
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 GILBERT ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-1538
Mailing Address - Country:US
Mailing Address - Phone:845-782-8616
Mailing Address - Fax:845-774-8870
Practice Address - Street 1:70 GILBERT ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-1538
Practice Address - Country:US
Practice Address - Phone:845-782-8616
Practice Address - Fax:845-774-8870
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229920208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02555920Medicaid