Provider Demographics
NPI:1831314368
Name:GOLDMAN, CRAIG STUART (DC)
Entity type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:STUART
Last Name:GOLDMAN
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 1:1 BENNINGTON PLACE
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751
Mailing Address - Country:US
Mailing Address - Phone:732-970-0455
Mailing Address - Fax:732-970-9448
Practice Address - Street 1:1 BENNINGTON PLACE
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751
Practice Address - Country:US
Practice Address - Phone:732-970-0455
Practice Address - Fax:732-970-9448
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00443100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor