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Individual

DR. IRA GARY GOLDBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
112 FULTON AVE # B, HEMPSTEAD, NY 11550-3752
(516) 481-2020
(516) 307-3305
Mailing address
112 FULTON AVE # B, HEMPSTEAD, NY 11550-3752
(516) 481-2020
(516) 620-9064

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV005281-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01558676
NY
01
113265536
UNITEDHEALTHCARE
NY
01
146056
VYTRA
NY
01
2146206
AETNA
NY
01
2160672
CIGNA
NY
01
37514P
HIP OF NEW YORK
NY
01
4C2296
HEALTHNET
NY
01
6500906
GHI
NY
01
C47481
EMPIRE BLUE CROSS BLUE SH
NY
01
P2077105
OXFORD
NY
Enumeration date
03/16/2007
Last updated
07/27/2012
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