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General NPI Number Information
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NPI Number | 1255514857
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Entity Type | Individual
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Provider Name | MS. SARA ELLEN GOOLD
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Gender | Female
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Dates
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Enumeration Date | 12/06/2007
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Last Update Date | 06/14/2019
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Provider Practice Location Address
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Address Line | 275 MADISON AVE STE 629
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City | NEW YORK
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State | NY
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Zip | 10016-1155
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Country | US
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Telephone | 203-247-9305
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Fax |
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Provider Business Mailing Address
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Address Line | 53 WELLSFORD DR
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City | GOSHEN
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State | CT
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Zip | 06756-1817
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Country | US
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Telephone | 203-247-9305
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number | 000781
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | 000781
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License Number State | NY
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