Individual
ELAN PHOEBE GOLOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
412 6TH AVE, 710, NEW YORK, NY 10011-8409
(212) 496-6003
(212) 496-4175
Mailing address
101 CLARK ST, 10E, BROOKLYN, NY 11201-2743
(718) 923-0408
(212) 496-4175
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V27541
MEDICARE PTAN
NY
Enumeration date
01/17/2007
Last updated
12/26/2012
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