Provider Demographics
NPI:1740271352
Name:GOLDSHMIDT, ALEXANDER (OPTICIAN)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:GOLDSHMIDT
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 HOMECREST AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4558
Mailing Address - Country:US
Mailing Address - Phone:718-232-3907
Mailing Address - Fax:718-234-8188
Practice Address - Street 1:7401 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5613
Practice Address - Country:US
Practice Address - Phone:718-232-3907
Practice Address - Fax:718-234-8188
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007466-1156FX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic