Individual
DR. LISA TAXMAN GOLDFARB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
118 SPRING ST, PORT JEFFERSON, NY 11777-1817
(631) 476-0564
(631) 476-9322
Mailing address
23 HOLLY BERRY CT, WADING RIVER, NY 11792-2157
(516) 503-1553
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
011631
NY
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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