Individual
GRIGORIY GOLDENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2792 OCEAN AVE FL 6, BROOKLYN, NY 11229-4730
(718) 332-5268
(718) 975-0632
Mailing address
20939 23RD AVE APT 2E, BAYSIDE, BAYSIDE, NY 11360-1826
(718) 332-5268
(718) 975-0632
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
207101
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
207101
NY
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
207101
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01862871
—
NY
Enumeration date
03/15/2006
Last updated
07/15/2013
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