Provider Demographics
NPI:1164765038
Name:GOLDSTEIN, KARLI PROVOST (DO)
Entity type:Individual
Prefix:DR
First Name:KARLI
Middle Name:PROVOST
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:204 CORLIES AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-1904
Mailing Address - Country:US
Mailing Address - Phone:832-577-3773
Mailing Address - Fax:
Practice Address - Street 1:779 NORTH ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-3105
Practice Address - Country:US
Practice Address - Phone:646-844-9602
Practice Address - Fax:646-846-2310
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY286616207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology