Provider Demographics
NPI:1225547698
Name:GOLDMAN, AARON (MED,)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:MED,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 BLAUVELT RD UNIT 202
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-2572
Mailing Address - Country:US
Mailing Address - Phone:347-779-6047
Mailing Address - Fax:
Practice Address - Street 1:105 SCHUNNEMUNK RD UNIT 112
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-6257
Practice Address - Country:US
Practice Address - Phone:845-477-5000
Practice Address - Fax:845-477-5131
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPO8064103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst