Provider Demographics
NPI:1023263050
Name:GOLDSTEIN, ERIC HARRIS (MSPT)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:HARRIS
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-1418
Mailing Address - Country:US
Mailing Address - Phone:845-354-2848
Mailing Address - Fax:845-362-7712
Practice Address - Street 1:165 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1418
Practice Address - Country:US
Practice Address - Phone:845-354-2848
Practice Address - Fax:845-362-7712
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015124225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist