Provider Demographics
NPI:1215559414
Name:SELBE NAGHSHINEH, GOLZAR (LP)
Entity Type:Individual
Prefix:MS
First Name:GOLZAR
Middle Name:
Last Name:SELBE NAGHSHINEH
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 MOTT ST APT 13
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-2810
Mailing Address - Country:US
Mailing Address - Phone:347-546-4238
Mailing Address - Fax:
Practice Address - Street 1:226 W 26TH ST FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6700
Practice Address - Country:US
Practice Address - Phone:347-546-4238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00163-01102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst