Provider Demographics
NPI:1992918809
Name:GOLDMAN, STEVEN (PSY D)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CLARK ST APT 11F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2736
Mailing Address - Country:US
Mailing Address - Phone:718-596-8618
Mailing Address - Fax:718-596-8618
Practice Address - Street 1:101 CLARK ST APT 11F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-2736
Practice Address - Country:US
Practice Address - Phone:718-596-8618
Practice Address - Fax:718-596-8618
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013810-1103T00000X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV529YOtherEMPIRE BLUE CROSS BLUE SH
NYP2538076OtherOXFORD INSURANCE
NY7566905OtherAETNA HEALTH INSURANCE