Individual
DR. IRA JAY GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 1ST AVE STE 5F, NEW YORK, NY 10016-6402
(212) 481-1350
Mailing address
630 W 168TH ST # 4, VC 12TH FLOOR, SUITE 208, NEW YORK, NY 10032-3725
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
127401
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00791240
—
NY
Enumeration date
01/04/2007
Last updated
04/01/2021
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