Provider Demographics
NPI:1902885486
Name:GOLDBERG, MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:19 BRADHURST AVE
Mailing Address - Street 2:SUITE 3100N
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-909-9018
Mailing Address - Fax:914-909-9028
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-7518
Practice Address - Fax:914-493-8130
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2021-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY215428207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133442196Other1199 NATIONAL BENEFIT
NY133442196OtherMAGNACARE
NYP3271011OtherOXFORD
NY133442196OtherTOUCHSTONE
NY2421235OtherUNITED HEALTHCARE
NY3C4062OtherHEALTHNET
NYMG03X54310OtherEMPIRE B/C B/S
NY179536OtherELDERPLAN
NY28P0661OtherNY PRESBYTERIAN
NY6096680OtherCIGNA
NYH48366Medicare UPIN
NY6096680OtherCIGNA
NY28P0661OtherNY PRESBYTERIAN