Individual
DEVORAH GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
570 1ST AVE, NEW YORK, NY 10016-6512
(901) 679-6701
Mailing address
1396 CARROLL ST, BROOKLYN, NY 11213-4404
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F308693-1
NY
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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