Goldman, Paul Russell

Goldman, Paul Russell is an sole proprietor health care provider with primary practice located at 19 Mansfield Dr , Massapequa Park NY 11762-4033. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Goldman, Paul Russell can be contacted via phone (516) 566-1398.

Contact Information

Primary practice address
19 Mansfield Dr Massapequa Park NY 11762-4033
Phone: (516) 566-1398
Fax: (516) 799-4542
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 010820 New York

Profile Details

NPI number 1669504130
LBN Legal business name Goldman, Paul Russell
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 11th, 2007
Last updated Jul 9th, 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 1669504130 NPPES
New York MEDICAID 02046179

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