Provider Demographics
NPI:1699955831
Name:GOLDIN, RENA JUDITH (PSYD)
Entity type:Individual
Prefix:DR
First Name:RENA
Middle Name:JUDITH
Last Name:GOLDIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1074 DARTMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-1906
Mailing Address - Country:US
Mailing Address - Phone:201-725-7158
Mailing Address - Fax:
Practice Address - Street 1:441 ROUTE 306
Practice Address - Street 2:SUITE 3
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-1233
Practice Address - Country:US
Practice Address - Phone:201-725-7158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017156103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical