# GARY GOLDBERG PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497024004
- **Authorized official:** GARY IRA GOLDBERG (CHIROPRACTOR)
- **Authorized official phone:** (718) 459-7575

## Contact information

- **Practice address:** 10420 QUEENS BLVD, FOREST HILLS, NY 11375-3629
- **Practice address phone:** (718) 459-7575
- **Practice address fax:** (718) 897-8604
- **Mailing address:** 10420 QUEENS BLVD, FOREST HILLS, NY 11375-3629
- **Mailing address phone:** (718) 459-7575
- **Mailing address fax:** (718) 897-8604

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X002005 | NY | Yes |

## Other

- **Enumeration date:** 12/28/2011
- **Last updated:** 01/04/2012