Basic Information
| Provider Information | |||||||||
| NPI: | 1245467786 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLDNER | ||||||||
| FirstName: | DANA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3959 BROADWAY FL 7 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100321559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123053000 | ||||||||
| FaxNumber: | 2123050914 | ||||||||
| Practice Location | |||||||||
| Address1: | 3959 BROADWAY FL 7 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100321559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123053000 | ||||||||
| FaxNumber: | 2123054343 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2009 | ||||||||
| LastUpdateDate: | 05/09/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | ME128279 | FL | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | L-240078 | MA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 265092 | NY | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080T0004X | 265092 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Transplant Hepatology |
No ID Information.