Provider Demographics
NPI:1871670612
Name:GOLDMAN, MAUREEN (MD)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:200 RIVERSIDE BLVD
Mailing Address - Street 2:APT. 6F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10069-0901
Mailing Address - Country:US
Mailing Address - Phone:212-539-2654
Mailing Address - Fax:212-595-3281
Practice Address - Street 1:30 5TH AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8859
Practice Address - Country:US
Practice Address - Phone:212-539-2654
Practice Address - Fax:212-595-3281
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2141182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H02439Medicare UPIN