Provider Demographics
NPI:1265638258
Name:GOLDSTEIN, REED DAVID (PHD)
Entity Type:Individual
Prefix:DR
First Name:REED
Middle Name:DAVID
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 S 8TH ST
Mailing Address - Street 2:OFFICE 140
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107
Mailing Address - Country:US
Mailing Address - Phone:215-829-7319
Mailing Address - Fax:215-829-7315
Practice Address - Street 1:245 S 8TH ST
Practice Address - Street 2:OFFICE 140
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-829-7319
Practice Address - Fax:215-829-7315
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006255L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical