Provider Demographics
NPI:1740277144
Name:GOLDBERG, NEAL D (MD)
Entity type:Individual
Prefix:
First Name:NEAL
Middle Name:D
Last Name:GOLDBERG
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 1:495 CENTRAL PARK AVE STE 305B
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1094
Mailing Address - Country:US
Mailing Address - Phone:914-722-1600
Mailing Address - Fax:914-722-1600
Practice Address - Street 1:128 ASHFORD AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1924
Practice Address - Country:US
Practice Address - Phone:914-722-1600
Practice Address - Fax:914-722-6982
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224305208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1507F1Medicare PIN
NYI03689Medicare UPIN