Individual
DR. CAROL GENE GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3375 PARK AVE, SUITE 4000, WANTAGH, NY 11793
(516) 364-5084
Mailing address
PO BOX 754, 40 QUEENS ST, SYOSSET, NY 11791-0754
(516) 364-5084
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1817
NJ
103T00000X
Psychologist
Primary
3668
NY
103T00000X
Psychologist
PY0004115
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02532685
—
NY
Enumeration date
02/14/2007
Last updated
07/08/2007
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