Goldman, Robert Jay

Goldman, Robert Jay is an individual health care provider with primary practice located at 6 Medical Dr , Port Jefferson Station NY 11776-1594. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Goldman, Robert Jay can be contacted via phone (631) 928-2655.

Contact Information

Primary practice address
6 Medical Dr Port Jefferson Station NY 11776-1594
Phone: (631) 928-2655
Fax: (631) 476-4635
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 026951 New York

Profile Details

NPI number 1427110428
LBN Legal business name Goldman, Robert Jay
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 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 1427110428 NPPES
New York MEDICAID 00654802

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