Individual
MELANIE M GOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10 RONALD REAGAN BLVD, WARWICK, NY 10990-4104
(845) 986-2058
(845) 986-7669
Mailing address
10 RONALD REAGAN BLVD, WARWICK, NY 10990-4104
(845) 986-2058
(845) 986-7669
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
220670-1
NY
208000000X
Pediatrics Physician
25MA87243700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0062511
—
NJ
05
—
02252440
—
NY
Enumeration date
10/05/2006
Last updated
05/06/2009
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