Provider Demographics
NPI:1831272269
Name:GOLDBERG, NEIL S (MD)
Entity type:Individual
Prefix:MR
First Name:NEIL
Middle Name:S
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:77 PONDFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708
Mailing Address - Country:US
Mailing Address - Phone:914-337-4499
Mailing Address - Fax:914-337-7082
Practice Address - Street 1:77 PONDFIELD ROAD
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708
Practice Address - Country:US
Practice Address - Phone:914-337-4499
Practice Address - Fax:914-337-7082
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY165846207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4205471OtherAETNA
0027416OtherGHI
WP0108OtherHEALTHNET
0487545OtherAETNA
6439888001OtherCIGNA
74D791OtherEMPIRE BCBS
WS0000646OtherSELECT PROVIDERS INC
WS1090OtherOXFORD
WS1090OtherOXFORD
4205471OtherAETNA