Active NPI
Jesse Lawton Goldberg, PHARMD
- Pharmacist
- Staten Island, NY
National Provider Identifier
1114301538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 059923
- Practice address
- 812 Forest Ave
Staten Island, NY 10310-2446 - Phone
- (718) 720-3700
- Fax
- (718) 720-5286
- NPI assigned
- Jul 15, 2015
- Last updated
- Jul 15, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 059923 | NY | Primary |
Addresses
Primary practice location
812 Forest Ave
Staten Island, NY 10310-2446
Mailing address
812 Forest Avenue
Staten Island, NY 10310
Phone (718) 720-3700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 059923 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436918400000",
"number": "1114301538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "812 FOREST AVENUE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "10310",
"telephone_number": "718-720-3700",
"fax_number": "718-720-5286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "812 FOREST AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103102446",
"telephone_number": "718-720-3700",
"fax_number": "718-720-5286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDBERG",
"first_name": "JESSE",
"middle_name": "LAWTON",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-15",
"last_updated": "2015-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "059923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.