Individual
JONATHAN I. GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2080 CLINTON AVE SOUTH, ROCHESTER, NY 14618
(585) 271-2800
(585) 271-0375
Mailing address
2080 CLINTON AVE SOUTH, ROCHESTER, NY 14618
(585) 271-2800
(585) 271-0375
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
257047
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02578343
MEDICAID GROUP ID
NY
05
—
03237038
—
NY
01
—
1366535940
GROUP NPI
NY
01
—
161563898
CIGNA
NY
01
—
7082043
AETNA - GROUP PIN
NY
01
—
7157888
AETNA - PIN
NY
01
—
AA0186
MEDICARE - GROUP ID
NY
01
—
CF8438
MEDICARE RAILROAD
NY
01
—
G0183898590
EXCELLUS
NY
Enumeration date
11/01/2006
Last updated
12/09/2015
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