Individual
IVAN GOLUB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-9111
Mailing address
MAIMONIDES MEDICAL CENTER, 4802 10TH AVE, BROOKLYN, NY 11219
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
1018314
MA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/01/2019
Last updated
05/29/2024
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