Provider Demographics
NPI:1073065710
Name:GOLDSZMID, LEAH (MA)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:GOLDSZMID
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:KAUFMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:711 AVENUE L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-5111
Mailing Address - Country:US
Mailing Address - Phone:917-587-5090
Mailing Address - Fax:
Practice Address - Street 1:711 AVENUE L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5111
Practice Address - Country:US
Practice Address - Phone:917-587-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist