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Individual

MS. JESSICA GOLDBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1275 YORK AVE, NEW YORK, NY 10065-6007
(646) 888-2726
Mailing address
1275 YORK AVE, NEW YORK, NY 10065-6007

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
307092
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
307092
NEW YORK DEPARTMENT OF EDUCATION
NY
Enumeration date
09/24/2014
Last updated
09/24/2014
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