Provider Demographics
NPI:1376872366
Name:GOLDNER, VIRGINIA IRIS (PHD)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:IRIS
Last Name:GOLDNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E 22ND ST
Mailing Address - Street 2:APT 10 H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5404
Mailing Address - Country:US
Mailing Address - Phone:212-982-9359
Mailing Address - Fax:
Practice Address - Street 1:102 E 22ND ST
Practice Address - Street 2:APT 10 A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5404
Practice Address - Country:US
Practice Address - Phone:212-982-9359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst