Provider Demographics
NPI:1427002153
Name:GOLDMAN, ALAN P (MD)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:P
Last Name:GOLDMAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2499
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11802-2499
Mailing Address - Country:US
Mailing Address - Phone:718-946-7557
Mailing Address - Fax:718-946-9680
Practice Address - Street 1:130 BRIGHTON BEACH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8002
Practice Address - Country:US
Practice Address - Phone:718-946-7557
Practice Address - Fax:718-946-9680
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY142903207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00884428Medicaid
C09567Medicare UPIN
NY00884428Medicaid