Individual
CHANIE GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS. ED
Contact information
Practice address
529 BROOKLYN AVE, 3D, BROOKLYN, NY 11225-5206
(347) 601-8123
Mailing address
529 BROOKLYN AVE, 3D, BROOKLYN, NY 11225
(347) 601-8123
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174400000X
AGENCY
—
Enumeration date
06/26/2012
Last updated
06/26/2012
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