Theodore Goldberg, MD
Obstetrics & Gynecology in Port Jefferson Station, New York
1750468435- Practice location
- 12 Medical Dr, Port Jefferson Station, NY 11776-1588
- Phone
- 631-331-4400
- Fax
- —
- Last updated
- September 10, 2009
Theodore Goldberg is an Obstetrics & Gynecology based in Port Jefferson Station, NY. Theodore Goldberg practices in Port Jefferson Station, NY and has the professional credentials of MD. The NPI Number for Theodore Goldberg is 1750468435 and holds a License No. 114421 (NY). The current practice location address for Theodore Goldberg is 12 Medical Dr, Port Jefferson Station, NY 11776-1588 and can be reached out via phone at 631-331-4400.
Provider Profile Details
- NPI Number
- 1750468435
- Provider Name
- Theodore Goldberg
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 12 Medical Dr, Port Jefferson Station, NY 11776-1588
- Phone Number
- 631-331-4400
- Primary Taxonomy
- Obstetrics & Gynecology · 207V00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- November 1, 2006
- Last Update Date
- September 10, 2009
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 12 Medical Dr
Port Jefferson Station, NY 11776-1588 - State
- New York
- Zip
- 11776-1588
- Phone Number
- 631-331-4400
Provider Business Mailing Address Details
- Address
- 22 Waterville RD
Avon, CT 06001-2066 - City
- Avon
- State
- CT
- Zip
- 06001-2066
License Information
- License Number (1)
- 114421
- License State (1)
- NY
- Taxonomy (1)
- Obstetrics & Gynecology · 207V00000X · Primary
- License Number (2)
- 114421
- License State (2)
- NY
- Taxonomy (2)
- Obstetrics & Gynecology, Gynecology · 207VG0400X
- License Number (3)
- 114421
- License State (3)
- NY
- Taxonomy (3)
- Obstetrics & Gynecology, Obstetrics · 207VX0000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Obstetrics & Gynecology providers near Port Jefferson Station, NY
View all Obstetrics & Gynecology providers in Port Jefferson Station →Frequently Asked Questions
What is the NPI number of Theodore Goldberg, MD?
The NPI number of Theodore Goldberg, MD is 1750468435. It was assigned on November 1, 2006 and is currently active in the NPPES registry.
What is the specialty of Theodore Goldberg, MD?
Theodore Goldberg, MD is registered under the primary taxonomy Obstetrics & Gynecology (code 207V00000X), licensed in NY under license number 114421.
Where does Theodore Goldberg, MD practice?
The practice location is 12 Medical Dr, Port Jefferson Station, NY 11776-1588. The office can be reached at 631-331-4400 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1750468435 directly on the NPPES registry website.