Provider Demographics
NPI:1104988765
Name:GOLDSMITH, MARLENE M (PHD)
Entity type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:M
Last Name:GOLDSMITH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 SHADY AVE
Mailing Address - Street 2:SUITE C207
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4409
Mailing Address - Country:US
Mailing Address - Phone:412-363-8779
Mailing Address - Fax:412-363-9727
Practice Address - Street 1:401 SHADY AVE
Practice Address - Street 2:SUITE C207
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4409
Practice Address - Country:US
Practice Address - Phone:412-363-8779
Practice Address - Fax:412-363-9727
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005021L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA607732OtherHIGHMARK, MEDICARE
PA110217OtherUPMC