Provider Demographics
NPI:1417161894
Name:GOLDBERG, ERIKA B (PHD)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:B
Last Name:GOLDBERG
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 1:2 5TH AVE APT 7J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8836
Mailing Address - Country:US
Mailing Address - Phone:917-992-3720
Mailing Address - Fax:
Practice Address - Street 1:80 UNIVERSITY PLACE
Practice Address - Street 2:4TH FLOOR SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-8856
Practice Address - Country:US
Practice Address - Phone:917-992-3720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017720103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical