Provider Demographics
NPI:1770688061
Name:GOLDIN, ARIEL ERIC (DC)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:ERIC
Last Name:GOLDIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-5118
Mailing Address - Country:US
Mailing Address - Phone:718-287-4200
Mailing Address - Fax:718-287-4225
Practice Address - Street 1:421 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5118
Practice Address - Country:US
Practice Address - Phone:718-287-4200
Practice Address - Fax:718-287-4225
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010648111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU95380Medicare UPIN
NYX5Z211Medicare ID - Type Unspecified