Provider Demographics
NPI:1134218134
Name:GOLDBERGER, MARCEL (MD)
Entity type:Individual
Prefix:DR
First Name:MARCEL
Middle Name:
Last Name:GOLDBERGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 STONELEIGH AVENUE
Mailing Address - Street 2:HOSPITAL PLAZA
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512
Mailing Address - Country:US
Mailing Address - Phone:845-279-2000
Mailing Address - Fax:845-279-3887
Practice Address - Street 1:660 STONELEIGH AVE
Practice Address - Street 2:HOSPITAL PLAZA
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-2451
Practice Address - Country:US
Practice Address - Phone:845-279-2000
Practice Address - Fax:845-279-3887
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY095782-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY095782-1OtherLICENSE
NY84001100Medicare ID - Type Unspecified