Individual
JAKE GOLDSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
350 HERB HILL RD APT 321, GLEN COVE, NY 11542-4407
(631) 871-1092
Mailing address
350 HERB HILL RD APT 321, GLEN COVE, NY 11542-4407
(631) 871-1092
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NY
251B00000X
Case Management Agency
—
—
Other
Enumeration date
01/20/2021
Last updated
01/20/2021
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