Individual
DR. MARK ALLAN GOLDSTEIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, YAW 6C PEDIATRIC GROUP PRACTICE, BOSTON, MA 02114-2621
(617) 726-2730
(617) 724-3948
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
37840
MA
2080A0000X
Pediatric Adolescent Medicine Physician
37840
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
037840
TUFTS HEALTH PLAN
MA
05
—
2062267
—
MA
01
—
C04787
BCBS MA
MA
Enumeration date
10/28/2005
Last updated
09/11/2025
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