Individual
DR. GARY GOLDENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5 E 98TH ST FL 5, NEW YORK, NY 10029-6501
(212) 241-9065
(212) 987-1197
Mailing address
245 EAST 87TH STREET, APT 10F, NEW YORK, NY 10128
(917) 209-9940
(212) 987-1197
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
250770
NY
207N00000X
Dermatology Physician
D66160
MD
207ND0900X
Dermatopathology Physician
250770
NY
207ND0900X
Dermatopathology Physician
D66160
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0034
CAREFIRST FEP
—
05
—
413500800
—
MD
01
—
89673801
CAREFIRST OF MARYLAND
MD
Enumeration date
01/26/2007
Last updated
10/30/2015
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