Individual
NICOLE GOLBARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 686-2517
Mailing address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
333046
NY
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
333046
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2019
Last updated
01/16/2026
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