Individual
THEODORE LYLE GOLDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7 PULASKI RD, EAST NORTHPORT, NY 11731-2442
(631) 261-3322
(631) 368-5440
Mailing address
7 PULASKI RD, EAST NORTHPORT, NY 11731-2442
(631) 261-3322
(631) 368-5440
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
184252
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01404388
—
NY
Enumeration date
03/29/2006
Last updated
07/08/2007
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