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NPI Code Detail

MEDICARE: MS. LYNN E. GOLDBERG L.C.S.W.

MEDICARE: MS. LYNN E. GOLDBERG L.C.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker73 076351NY

General Provider Information

NPI Number : 1235386624
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LYNN E. GOLDBERG L.C.S.W.
Provider Business Mailing Address
First Line : 1517 GRENOSIDE AVENUE
Second Line :
City : NISKAYUNA
State : NY
Zip : 12309
Country : US
Telephone Number : 518-280-9177
Fax Number : 518-370-0317
Provider Business Practice Location Address
First Line : 3512 QUENTIN RD
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-4231
Country : US
Telephone Number : 800-275-3243
Fax Number : 800-275-3671
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2008
Last Update Date : 06/28/2012

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