Provider Demographics
NPI:1720273410
Name:GOLDSTEIN, JASON SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:SCOTT
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:330 W 58TH ST
Mailing Address - Street 2:APT 501
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1818
Mailing Address - Country:US
Mailing Address - Phone:212-582-1122
Mailing Address - Fax:212-582-1122
Practice Address - Street 1:250 W 54TH ST
Practice Address - Street 2:FLOOR 3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5515
Practice Address - Country:US
Practice Address - Phone:917-572-5834
Practice Address - Fax:212-262-9178
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2020-02-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY011443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor