Provider Demographics
NPI:1134505688
Name:GOLDSTEIN, ERICA
Entity Type:Individual
Prefix:MISS
First Name:ERICA
Middle Name:
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E 30TH ST
Mailing Address - Street 2:APARTMENT 8N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6416
Mailing Address - Country:US
Mailing Address - Phone:516-359-3786
Mailing Address - Fax:
Practice Address - Street 1:333 E 30TH ST
Practice Address - Street 2:APARTMENT 8N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6416
Practice Address - Country:US
Practice Address - Phone:516-359-3786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024700-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist