Provider Demographics
NPI:1093742181
Name:GOLDSMITH, MARIAN (MS, AUDIOLOGY)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:
Last Name:GOLDSMITH
Suffix:
Gender:F
Credentials:MS, AUDIOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 JENKINS ST
Mailing Address - Street 2:
Mailing Address - City:ENDWELL
Mailing Address - State:NY
Mailing Address - Zip Code:13760-3219
Mailing Address - Country:US
Mailing Address - Phone:607-754-8756
Mailing Address - Fax:607-786-3616
Practice Address - Street 1:800 HOOPER RD
Practice Address - Street 2:SUITE 370
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-1560
Practice Address - Country:US
Practice Address - Phone:607-786-5130
Practice Address - Fax:607-786-4637
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000133231H00000X
NY14000008836237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter