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General NPI Number Information
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NPI Number | 1609822923
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Entity Type | Individual
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Provider Name | JEFFREY HOWARD GOIDEL PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 25 HEMLOCK DR
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City | CONGERS
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State | NY
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Zip | 10920-1401
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Country | US
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Telephone | 845-267-0110
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Fax | 845-267-2634
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Provider Business Mailing Address
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Address Line | 7 WINDGATE DR
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City | NEW CITY
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State | NY
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Zip | 10956-4434
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Country | US
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Telephone | 845-638-0198
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 008917
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License Number State | NY
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