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General NPI Number Information
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NPI Number | 1689482929
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Entity Type | Organization
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Legal Business Name | SHAHLA GOROVOY PSYCHOLOGIST PC
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 225 DOLSON AVE STE 206A
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City | MIDDLETOWN
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State | NY
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Zip | 10940-6570
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Country | US
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Telephone | 845-342-6461
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Fax | 845-299-2984
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Provider Business Mailing Address
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Address Line | 180 PINE TREE RD
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City | MONROE
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State | NY
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Zip | 10950-3964
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAHLA GOROVOY
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Credential | PHD
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Telephone | 845-325-6202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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