Provider Demographics
NPI:1063420214
Name:GOLDMANN, TRUDIE (PH D)
Entity type:Individual
Prefix:DR
First Name:TRUDIE
Middle Name:
Last Name:GOLDMANN
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 CEDAR HILL RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10506-2042
Mailing Address - Country:US
Mailing Address - Phone:914-234-3433
Mailing Address - Fax:
Practice Address - Street 1:16 DAKIN AVE
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2826
Practice Address - Country:US
Practice Address - Phone:914-666-2927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004696-01103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical