Provider Demographics
NPI:1740360643
Name:GOLDSTEIN, STEVEN B (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:B
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 ATLANTIC AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3545
Mailing Address - Country:US
Mailing Address - Phone:516-887-1001
Mailing Address - Fax:516-887-1004
Practice Address - Street 1:215 ATLANTIC AVE
Practice Address - Street 2:SUITE A
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-3545
Practice Address - Country:US
Practice Address - Phone:516-887-1001
Practice Address - Fax:516-887-1004
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3915111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX3915OtherLICENSE NUMBER
NYX21451Medicare ID - Type Unspecified