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General NPI Number Information
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NPI Number | 1831261221
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Entity Type | Individual
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Provider Name | RUTH B GOLDBERG PHD
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Gender | Female
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 07/08/2009
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Provider Practice Location Address
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Address Line | 4 CHELMSFORD RD
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City | ROCHESTER
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State | NY
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Zip | 14618-1755
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Country | US
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Telephone | 585-271-3050
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Fax | 585-271-7313
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Provider Business Mailing Address
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Address Line | 4 CHELMSFORD RD
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City | ROCHESTER
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State | NY
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Zip | 14618-1755
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Country | US
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Telephone | 585-271-3050
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Fax | 585-271-7313
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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 | 0087111
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License Number State | NY
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