Individual
GARY LESLIE GOLDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6782 SELFRIDGE ST, FOREST HILLS, NY 11375-5739
(718) 261-4624
Mailing address
6782 SELFRIDGE ST, FOREST HILLS, NY 11375-5739
(718) 607-1505
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
60264330
NY
207RX0202X
Medical Oncology Physician
Primary
60264330
NY
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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