Goldberg, Theodore

Goldberg, Theodore is an individual health care provider with primary practice located at 12 Medical Dr , Port Jefferson Station NY 11776-1588. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is his primary health care specialty. Goldberg, Theodore can be contacted via phone (631) 331-4400.

Contact Information

Primary practice address
12 Medical Dr Port Jefferson Station NY 11776-1588
Phone: (631) 331-4400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 114421 New York
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 114421 New York
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X 114421 New York

Profile Details

NPI number 1750468435
LBN Legal business name Goldberg, Theodore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Sep 10th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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