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THEODORE GOLDBERG M.D.
NPI 1750468435
Obstetrics & Gynecology in Port Jefferson Station, NY

Active since November 01, 2006
12 MEDICAL DR, PORT JEFFERSON STATION, NY 11776(631) 331-4400 Get Directions Write a Review

NPPES record last updated: September 10, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Theodore Goldberg M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THEODORE GOLDBERG M.D. (NPI 1750468435) is an individual obstetrics & gynecology provider in Port Jefferson Station, New York, licensed in New York (114421) and active in the NPI registry since November 2006.

NPPES Registry Identity

NPI1750468435
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameTHEODORE GOLDBERGCredential: M.D.
Location Address12 MEDICAL DRPort Jefferson Station, NY 11776-1588
Mailing Address22 Waterville RdAvon, CT 06001-2066
Phone(631) 331-4400
Sole ProprietorNo
Enumeration DateNovember 1, 2006
Last NPPES UpdateSeptember 10, 2009
✔ NPI 1750468435 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in NY · 114421
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Also ListedObstetrics & Gynecology · GynecologyTaxonomy 207VG0400X · License 114421 (NY)
Also ListedObstetrics & Gynecology · ObstetricsTaxonomy 207VX0000X · License 114421 (NY)
12 MEDICAL DR, Port Jefferson Station, NY 11776
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Other Identifiers 1

Medicare ID-Type Unspecified973132NY · Empire Medicare

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATHERINE G ROTH MD
Psychiatry & Neurology (Neurology)
12 MEDICAL DR, STE D
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 928-1222
MS. JACQUELINE PANDOLFI N.P.
Nurse Practitioner (Women's Health)
12 MEDICAL DR
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 331-4400
PORT JEFFERSON PEDIATRICS
Pediatrics
12 MEDICAL DR
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 331-1710
DREUX PATTON M.D.
Obstetrics & Gynecology
12 MEDICAL DR
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 331-4400
DR. MARTIN P KAPLAN MD
Pediatrics
12 MEDICAL DR
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 331-1710
WENDY FARRAR RN, NP, -C, MS
Nurse Practitioner
12 MEDICAL DR
PORT JEFFERSON STATION, NY 11776
Suffolk County (631) 331-4400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Goldberg's NPI number?

The NPI number for Theodore Goldberg is 1750468435. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Where is Theodore Goldberg located?

Theodore Goldberg practices at 12 Medical Dr, Port Jefferson Station, NY 11776. The listed phone number is (631) 331-4400.

What is Theodore Goldberg's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

When was this NPI record last updated?

The NPPES record for Theodore Goldberg was last updated on September 10, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.