Provider Demographics
NPI:1952479487
Name:GOLDSTEIN, JOSHUA (L AC , MTOM)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:L AC , MTOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:69 W RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3142
Mailing Address - Country:US
Mailing Address - Phone:201-444-7150
Mailing Address - Fax:201-444-7151
Practice Address - Street 1:69 W EST RIDGEWOOD AVENUE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3142
Practice Address - Country:US
Practice Address - Phone:201-444-7150
Practice Address - Fax:201-444-7151
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00010700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist