Provider Demographics
NPI:1801976816
Name:GOLDBERG, ARTHUR (DC)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:GOLDBERG
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 1:49 BERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-2624
Mailing Address - Country:US
Mailing Address - Phone:516-921-3566
Mailing Address - Fax:516-921-3285
Practice Address - Street 1:49 BERRY HILL RD
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-2624
Practice Address - Country:US
Practice Address - Phone:516-921-3566
Practice Address - Fax:516-921-3285
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
NYX000808-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYLNDMKOtherLANDMARK
NY04298OtherPHCS
NY41159OtherMPN
NY87726OtherUNITED
NYP957751OtherOXFORD
NYX0160OtherBCBS
NY22099OtherHORIZON
NY62308OtherCIGNA
NY7274OtherVYTRA
NY0059781OtherGHI
NYX01601Medicare ID - Type Unspecified