MEDICARE: METRO PSYCHOLOGICAL EVALUATION, P.C.

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
1	103T00000X	Psychologist	010735	NY

General Provider Information

NPI Number	:	1245470335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METRO PSYCHOLOGICAL EVALUATION, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 482
Second Line	:
City	:	HEWLETT
State	:	NY
Zip	:	11557-0482
Country	:	US
Telephone Number	:	917-952-0942
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 8TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3910
Country	:	US
Telephone Number	:	917-952-0942
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOLOGIST
Name	:	DR. WARREN GOLDBERG
Credential	:	PH.D.
Telephone Number	:	917-952-0942

Provider Enumeration Date	:	03/02/2009
Last Update Date	:	10/08/2019

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