Provider Demographics
NPI:1912052515
Name:GOLDMAN & LEVINE ENDODONTICS LLC
Entity Type:Organization
Organization Name:GOLDMAN & LEVINE ENDODONTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDMAN,
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:718-761-1200
Mailing Address - Street 1:165 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5414
Mailing Address - Country:US
Mailing Address - Phone:718-761-1200
Mailing Address - Fax:718-494-3883
Practice Address - Street 1:165 WESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-5414
Practice Address - Country:US
Practice Address - Phone:718-761-1200
Practice Address - Fax:718-494-3883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0396761223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty