Provider Demographics
NPI:1265738926
Name:GOLDSTEIN, GITTEL (NP)
Entity type:Individual
Prefix:
First Name:GITTEL
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 58TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4529
Mailing Address - Country:US
Mailing Address - Phone:718-435-2184
Mailing Address - Fax:
Practice Address - Street 1:2925A KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1805
Practice Address - Country:US
Practice Address - Phone:718-382-0045
Practice Address - Fax:718-382-0051
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-28
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY40401351363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health