Stephen Golub, MD

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

1421871 Issued in NY

Practice address

118 North Country Road
Port Jefferson, NY 11777

Phone

(631) 473-7171

Fax

(631) 473-4605

NPI assigned

Dec 4, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Port Jefferson OBGYN PC

  • Obstetrics & Gynecology Physician
  • Port Jefferson, NY
  • NPI 1073689477
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1568520708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 NORTH COUNTRY ROAD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "11777",
            "telephone_number": "631-473-7171",
            "fax_number": "631-473-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 NORTH COUNTRY ROAD",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "11777",
            "telephone_number": "631-473-7171",
            "fax_number": "631-473-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLUB",
        "first_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "142187",
            "primary": false
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NY",
            "license": "1421871",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC",
            "identifier": "1421871",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYS LICENSE",
            "identifier": "1461871",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maureen Godfrey
• Yigit Ali Gol, DDS
• Nicole Golbari
• Lauren Beth Goldstein, MS, CCC, SLP
• Peter Goldstein, RPH
• Patricia Gomez
• Linda Concetta Gonzalez, LMT
• Stacey Gonzalez, NP
• Good Samaritan Hospital Medical Center
• Alexander Gorbatsevich, M.D.

• Gynecology Physician in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.