Individual
DIVYA V GOLDSTEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
201 LYONS AVE, SUITE L-4, NEWARK, NJ 07112-2027
(917) 703-7660
Mailing address
208 HUTTON ST, JERSEY CITY, NJ 07307-3704
(917) 703-7660
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA07871300
NJ
207RC0000X
Cardiovascular Disease Physician
225226
NY
207RC0000X
Cardiovascular Disease Physician
Primary
25MAO7871300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0081566
—
NJ
01
—
096041
MEDICARE PTAN
NJ
Enumeration date
09/20/2006
Last updated
07/30/2021
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