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Organization

BEACH BUNGALO LIMITED LIABILITY COMPANY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHERRY LYNN GOLDMAN LCSW (PRESIDENT)
(732) 557-0354
Entity
Organization

Contact information

Practice address
892 COMMON WAY, SUITE H, TOMS RIVER, NJ 08753
(732) 557-0354
(732) 286-4334
Mailing address
712 E LONG BRANCH AVENUE, BAYVILLE, NJ 08721
(732) 557-0354
(732) 286-4334

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
NJ
1041C0700X
Clinical Social Worker
Primary
44SC05201900
NJ

Other

Enumeration date
02/26/2007
Last updated
11/15/2007
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