Provider Demographics
NPI:1184860991
Name:GOLDSTEIN, BARBARA LAURA (PT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:LAURA
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9805 63RD RD
Mailing Address - Street 2:#7E
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1744
Mailing Address - Country:US
Mailing Address - Phone:718-459-7798
Mailing Address - Fax:718-459-7798
Practice Address - Street 1:9805 63RD RD
Practice Address - Street 2:#7E
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1744
Practice Address - Country:US
Practice Address - Phone:718-459-7798
Practice Address - Fax:718-459-7798
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010862174400000X
PAPT-008985-E174400000X
AZ2078174400000X
CT005504174400000X
NM1225174400000X
UT00899-2401-0174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist