Provider Demographics
NPI:1871697995
Name:GOLDMAN, STEVEN LOUIS (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:LOUIS
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HIGH ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-7605
Mailing Address - Country:US
Mailing Address - Phone:631-549-5864
Mailing Address - Fax:631-549-2869
Practice Address - Street 1:7 HIGH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-7605
Practice Address - Country:US
Practice Address - Phone:631-549-5864
Practice Address - Fax:631-549-2869
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106700207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY110085836OtherMEDICARE RR
NY0673125Medicaid
NY0673125Medicaid
NY967481Medicare PIN