Goldberg, Mark

Goldberg, Mark is an sole proprietor health care provider with primary practice located at 9 Technology Dr , East Setauket NY 11733-4000. He recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotic Fitter. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist is his primary health care specialty. Goldberg, Mark can be contacted via phone (631) 689-6606.

Contact Information

Primary practice address
9 Technology Dr East Setauket NY 11733-4000
Phone: (631) 689-6606
Fax: (631) 941-3525
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist 222Z00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist 224P00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotic Fitter 225000000X

Profile Details

NPI number 1114015690
LBN Legal business name Goldberg, Mark
Credentials C.P.O
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 10th, 2006
Last updated Jul 8th, 2007 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1114015690 NPPES
New York MEDICAID 01077018

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