Provider Demographics
NPI:1962726877
Name:GOLDMAN, BARBARA ANN (CO)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:ANN
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 MAIN ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-2597
Mailing Address - Country:US
Mailing Address - Phone:570-421-1110
Mailing Address - Fax:570-421-1207
Practice Address - Street 1:437 MAIN ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-2597
Practice Address - Country:US
Practice Address - Phone:570-421-1110
Practice Address - Fax:570-421-1207
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACO004236174H00000X
PAC19355174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator