Healthcare Provider Details

I. General information

NPI: 1659202562
Provider Name (Legal Business Name): TZURTEL GOLDBERGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HAMASPIK WAY FL 2
MONROE NY
10950-8451
US

IV. Provider business mailing address

1 HAMASPIK WAY FL 2
MONROE NY
10950-8451
US

V. Phone/Fax

Practice location:
  • Phone: 845-774-8400
  • Fax:
Mailing address:
  • Phone: 845-774-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number125113
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: