Goldman, Theodore Lyle

Goldman, Theodore Lyle is an individual health care provider with primary practice located at 7 Pulaski Rd , East Northport NY 11731-2442. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Goldman, Theodore Lyle can be contacted via phone (631) 261-3322.

Contact Information

Primary practice address
7 Pulaski Rd East Northport NY 11731-2442
Phone: (631) 261-3322
Fax: (631) 368-5440
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 184252 New York

Profile Details

NPI number 1912968181
LBN Legal business name Goldman, Theodore Lyle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2006
Last updated Jul 8th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1912968181 NPPES
New York MEDICAID 01404388

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