Mark Jason Goldman MD

NPI 1053512285 - Internal Medicine - 207RC0000X

NPI Details
NPI 1053512285
Gender Male
Enumeration Date 05/28/2007
Last Updated 07/02/2014
Entity Type Individual
Active Over 9 years ago
Practice Location
61 SOUTHERN BLVD
NESCONSET NY, 11767-1089, US
Phone (631) 659-1800
Fax (631) 382-4836
Business Location
61 E MAIN ST
BAY SHORE NY, 11706-8366, US
Phone (631) 659-1600
Fax (631) 665-5870
Toxanomy
Taxonomy Code 207RC0000X
License State New York
License Number 239823
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According to our database, Dr. Mark Jason Goldman MD NPI is 1053512285, taxonomy code is 207RC0000X and license number is 239823, license state is located at New York. Mark Jason Goldman MD physically located at 61 Southern Blvd, Nesconset NY, 11767-1089. NPI Number Mark Jason Goldman MD has the Individual type.

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1053512285 NPI number is provided on an as is basis without warranty of any kind. 1053512285 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Jason Goldman MD are for informational purposes only.