Provider Demographics
NPI:1578912127
Name:SHARI GOLDSTEIN
Entity Type:Organization
Organization Name:SHARI GOLDSTEIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SHRI
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC
Authorized Official - Phone:203-856-7368
Mailing Address - Street 1:4 LAKEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5114
Mailing Address - Country:US
Mailing Address - Phone:203-856-7368
Mailing Address - Fax:203-341-0127
Practice Address - Street 1:4 LAKEVIEW RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5114
Practice Address - Country:US
Practice Address - Phone:203-856-7368
Practice Address - Fax:203-341-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-05
Last Update Date:2016-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002161235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty