THEODORE GOLDBERG

PORT JEFFERSON STATION, NY
NPI1750468435
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207V00000X Obstetrics & Gynecology
(Licence: NY  114421)
Additional Taxonomies207VG0400X Obstetrics & Gynecology, Gynecology
(Licence: NY  114421)
207VX0000X Obstetrics & Gynecology, Obstetrics
(Licence: NY  114421)
Enumeration Date2006-11-01
Last Update Date2009-09-10
Business Address
-- THEODORE GOLDBERG M.D.
12 MEDICAL DR
PORT JEFFERSON STATION, NY 11776-1588
Phone number: 631-331-4400
Mailing Address
-- THEODORE GOLDBERG M.D.
22 WATERVILLE RD
AVON, CT 06001-2066
Phone number: