| Doctor Name: | DR. MARK JASON GOLDMAN |
| NPI Number: | 1053512285 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 239823 |
| Business Practice Address: | 61 Southern Blvd Nesconset, NY - 117671089 |
| Business Phone Number: | 6316591800 |
| Business Fax Number: | 6313824836 |
| Mailing Address: | 61 E Main St, BAY SHORE |
| State: | NY |
| Postal Code: | 117068366 |
| Phone Number: | 6316591600 |
| Fax Number: | 6316655870 |
| NPI Enumeration Date: | 05/28/2007 |
| NPI Last Update Date: | 07/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RC0000X |
| License Number: | 239823 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Cardiovascular Disease |
| Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |