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General NPI Number Information
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NPI Number | 1427275700
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Entity Type | Individual
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Provider Name | GERALDINE VICKI GOLDMAN CRC
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9502 ROCKAWAY BEACH BLVD
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City | ROCKAWAY BEACH
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State | NY
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Zip | 11693-1317
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Country | US
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Telephone | 718-474-2478
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Fax |
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Provider Business Mailing Address
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Address Line | 3111 TRINITY ST
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City | OCEANSIDE
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State | NY
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Zip | 11572-3222
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Country | US
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Telephone | 516-764-5744
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 00003406
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License Number State | NY
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