Goldenberg Dermatology, PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

250770 Issued in NY

Legal business name

GOLDENBERG DERMATOLOGY, PC

Practice address

14 E 75TH St
1B
New York, NY 10021-2625

Phone

(917) 209-9940

NPI assigned

Feb 7, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Gary Goldenberg, MDNPI 1336295955

Title

President

Phone

(917) 209-9940

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristina Goldenberg, M.D.

  • Dermatology Physician
  • New York, NY
  • NPI 1801183033
  Medicare reassignment NPD
• Gary Goldenberg, MD

  • Dermatology Physician
  • New York, NY
  • NPI 1336295955
  NPD Authorized official
• Kent Shinbach, M.D.

  • Prescribing (Medical) Psychologist
  • New York, NY
  • NPI 1992762793
  NPD (past)

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1720526007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 E 75TH ST",
            "address_2": "1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212625",
            "telephone_number": "917-209-9940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 E 75TH ST",
            "address_2": "1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100212625",
            "telephone_number": "917-209-9940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDENBERG DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-07",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "GOLDENBERG",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-209-9940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "250770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Mark Golden, DDS
• Samuel Golden, PSY.D.
• Sima Golden, M.S.
• Tatiana Victoria Golden
• Tyler Scott Golden, DC
• Bess M Goldenberg Witlin, MSW
• Alec S Goldenberg, MD
• Alyson Michele Goldenberg, NP
• Alyssa Goldenberg, LMSW
• Barry Goldenberg, MD PC

• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.