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Individual

DR. MICHAEL ELLIS GOLDBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
710 W 168TH STREET, NEW YORK, NY 10032-2699
(212) 543-6931
(212) 543-5816
Mailing address
710 W 168TH STREET, NEW YORK, NY 10032-2699
(212) 543-6931
(212) 543-5816

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
225939-1
NY
208M00000X
Hospitalist Physician
Primary
225939
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02702298
NY
Enumeration date
09/20/2006
Last updated
03/26/2020
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