IndividualActive
Theodore Goldberg, M.D.
NPI 1750468435 · Obstetrics & Gynecology Physician · Port Jefferson Station, NY
Provider details
- NPI number
- 1750468435
- Entity type
- Individual
- Primary specialty
- Obstetrics & Gynecology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 114421 (NY)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12 Medical Dr
Port Jefferson Station, NY 11776-1588
Phone: (631) 331-4400
Street-level locationGet directions
Mailing address
22 Waterville Rd
Avon, CT 06001-2066
Registry dates
- Enumerated
- 2006-11-01
- Last updated
- 2009-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.