Provider Demographics
NPI:1124172861
Name:GOLDMAN, ROBERT T (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:T
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:110 S. BEDFORD ROAD
Mailing Address - Street 2:MOUNT KISCO MEDICAL GROUP PC
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:914-241-1050
Mailing Address - Fax:914-242-1516
Practice Address - Street 1:310 N HIGHLAND AVE STE 4
Practice Address - Street 2:MOUNT KISCO MEDICAL GROUP PC
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-6301
Practice Address - Country:US
Practice Address - Phone:914-468-2590
Practice Address - Fax:914-468-8591
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2013-11-14
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Provider Licenses
StateLicense IDTaxonomies
NY202109207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02252037Medicaid
NYP01212360OtherRAILROAD MEDICARE
NYA400067002Medicare PIN
NY97G241Medicare PIN
NYP01212360OtherRAILROAD MEDICARE