Individual
DR. MICHAEL M GOLDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12046 QUEENS BLVD, KEW GARDENS, NY 11415-1204
(718) 793-3341
(718) 268-1666
Mailing address
97 NEW DORP LN STE A, STATEN ISLAND, NY 10306-2364
(718) 876-6220
(718) 876-5969
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
260759
NY
207RN0300X
Nephrology Physician
Primary
260759
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03331142
—
NY
Enumeration date
03/09/2010
Last updated
12/05/2024
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