Basic Information
Provider Information
NPI: 1316310329
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GOLDSTEIN
FirstName: BARBARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BUNIOWSKA
OtherFirstName: BARBARA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 300 COMMUNITY DR
Address2: DEPARTMENT OF ANESTHESIA
City: MANHASSET
State: NY
PostalCode: 110303816
CountryCode: US
TelephoneNumber: 5169453156
FaxNumber:  
Practice Location
Address1: 68 S SERVICE RD
Address2: SUITE 350
City: MELVILLE
State: NY
PostalCode: 117472354
CountryCode: US
TelephoneNumber: 5169453156
FaxNumber: 5169453131
Other Information
ProviderEnumerationDate: 11/12/2015
LastUpdateDate: 11/12/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X598879-1NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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