MEDICARE: DR. RACHEL L GOLDMAN PH.D.

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	103TC0700X	Clinical Psychologist	019157	NY
2	390200000X	Student in an Organized Health Care Education/Training Program
3	103T00000X	Psychologist	019157	NY

General Provider Information

NPI Number	:	1457641367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHEL L GOLDMAN PH.D.

Provider Business Mailing Address
First Line	:	800 THIRD AVENUE, FRNT A
Second Line	:	#1719
City	:	NEW YORK
State	:	NY
Zip	:	10022
Country	:	US
Telephone Number	:	646-694-2445
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 3RD AVE # 1719
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-7649
Country	:	US
Telephone Number	:	646-694-2445
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2011
Last Update Date	:	03/31/2025

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