Provider Demographics
NPI:1033104146
Name:GOLDKLANG, STANLEY CURT (PHD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:CURT
Last Name:GOLDKLANG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 GLENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1411
Mailing Address - Country:US
Mailing Address - Phone:516-621-1025
Mailing Address - Fax:516-621-3064
Practice Address - Street 1:60 GLENWOOD LN
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1411
Practice Address - Country:US
Practice Address - Phone:516-621-1025
Practice Address - Fax:516-621-3064
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007276-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY077594OtherVALUE OPTIONS
NYV26521Medicaid
0073403OtherGHI PROVIDER NUMBER
236510OtherMHN PROVIDER NUMBER
NYV26521Medicaid