Organization
BESPOKE SURGICAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVAN BRAD GOLDSTEIN D.O. (OWNER)
(917) 570-4437
Entity
Organization
Contact information
Practice address
160 7TH AVE S, NEW YORK, NY 10014-2727
(212) 206-1501
(888) 880-8621
Mailing address
160 7TH AVE S, NEW YORK, NY 10014-2727
(212) 206-1501
(888) 880-8621
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
208600000X
Surgery Physician
Primary
—
NY
Other
Enumeration date
06/15/2010
Last updated
12/11/2013
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