Basic Information
| Provider Information | |||||||||
| NPI: | 1588775183 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLDSHTEYN | ||||||||
| FirstName: | NATALYA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5450 | ||||||||
| Address2: | EAST PAVILION 3RD FLOOR NY METHODIST HOSPITAL | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10087 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187805246 | ||||||||
| FaxNumber: | 7187803259 | ||||||||
| Practice Location | |||||||||
| Address1: | 506 6TH ST | ||||||||
| Address2: | EAST PAVILION 3RD FLOOR NEW YORK METHODIST HOSPITAL | ||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112153609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187805246 | ||||||||
| FaxNumber: | 7187803259 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 05/17/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 231433 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
ID Information
| ID | Type | State | Issuer | Description | 02655732 | 05 | NY | MEDICAID |