Individual
DR. LEONARD I GOLDSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
133 SCOVILL ST, SUITE 211, WATERBURY, CT 06706-1127
(203) 573-9521
(203) 573-8708
Mailing address
133 SCOVILL ST, SUITE 211, WATERBURY, CT 06706-1127
(203) 573-9521
(203) 573-8708
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
001856
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004132007
—
CT
01
—
060001856CT01
BLUE SHIELD
CT
Enumeration date
08/30/2006
Last updated
09/15/2010
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