Provider Demographics
NPI:1124524863
Name:GOLDSTEIN, MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 MINEOLA BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4089
Mailing Address - Country:US
Mailing Address - Phone:516-663-5311
Mailing Address - Fax:516-663-4780
Practice Address - Street 1:101 MINEOLA BLVD FL 2
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-4089
Practice Address - Country:US
Practice Address - Phone:516-663-3511
Practice Address - Fax:516-663-4780
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY308626207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism