NPI 1114015690

Mark Goldberg, CPO

Practitioner Orthotic Fitter East Setauket, NY

Practice location

Address: 9 Technology Dr, East Setauket, NY 11733-4000
Phone: (631) 689-6606
Fax: (631) 941-3525

Registered specialties (3)

Orthotic Fitter Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225000000X

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Orthotist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 222Z00000X

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Prosthetist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X

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Registry record

NPI: 1114015690
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Oct 2006
Record last updated: 11 Sep 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.