Individual
MS. SHOSHANA BRACHA GOLDWAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
255 EXECUTIVE DR, PLAINVIEW, NY 11803-1718
(516) 576-2040
Mailing address
261 BEDELL TER, WEST HEMPSTEAD, NY 11552-2444
(516) 538-8536
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
0144861
NY
Other
Enumeration date
02/24/2009
Last updated
02/24/2009
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