Provider Demographics
NPI:1568526481
Name:GOODMAN, PATRICIA JOYCE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:JOYCE
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:143 BEACON HILL DR
Mailing Address - Street 2:#H23
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-2461
Mailing Address - Country:US
Mailing Address - Phone:914-714-2263
Mailing Address - Fax:914-693-0210
Practice Address - Street 1:547 SAW MILL RIVER RD
Practice Address - Street 2:SUITE 2F
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-2143
Practice Address - Country:US
Practice Address - Phone:914-714-2263
Practice Address - Fax:914-693-0210
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014775103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02195628Medicaid
NY02195628Medicaid