Provider Demographics
NPI:1316310329
Name:GOLDSTEIN, BARBARA
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:
Other - Last Name:BUNIOWSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 COMMUNITY DR
Mailing Address - Street 2:DEPARTMENT OF ANESTHESIA
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3816
Mailing Address - Country:US
Mailing Address - Phone:516-945-3156
Mailing Address - Fax:
Practice Address - Street 1:68 S SERVICE RD
Practice Address - Street 2:SUITE 350
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-2354
Practice Address - Country:US
Practice Address - Phone:516-945-3156
Practice Address - Fax:516-945-3131
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY598879-1367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered