Provider Demographics
NPI:1154547107
Name:GOLDSTEIN, BARBARA (PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:GOLDSTEIN
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 1:744 SPARROW DR
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05352-9667
Mailing Address - Country:US
Mailing Address - Phone:802-694-1239
Mailing Address - Fax:802-694-1720
Practice Address - Street 1:11835 QUEENS BLVD
Practice Address - Street 2:SUITE 1430
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7200
Practice Address - Country:US
Practice Address - Phone:718-773-8888
Practice Address - Fax:718-261-1915
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00065231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4524005OtherAETNA
NY98033AMedicare ID - Type Unspecified
NY4524005OtherAETNA