Provider Demographics
NPI:1366533119
Name:GOLDSTEIN, EVELYN M (NP)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:M
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:333 WASHINGTON AVE N
Mailing Address - Street 2:SUITE 5000
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-1377
Mailing Address - Country:US
Mailing Address - Phone:612-659-7111
Mailing Address - Fax:612-659-7101
Practice Address - Street 1:4247 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-6220
Practice Address - Country:US
Practice Address - Phone:718-605-4000
Practice Address - Fax:718-605-4040
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2019-08-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF331799-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner