Individual
BRUCE MARTIN GOLDSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
195 SESSIONS ST, PROVIDENCE, RI 02906-3442
(401) 274-4578
Mailing address
195 SESSIONS ST, PROVIDENCE, RI 02906-3442
(401) 274-4578
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
49083
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0152692
—
MA
Enumeration date
11/16/2005
Last updated
01/14/2019
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