Provider Demographics
NPI:1598141541
Name:MCGOLDRICK, THOMAS JOSEPH (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOSEPH
Last Name:MCGOLDRICK
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 1:36 W 11TH ST
Mailing Address - Street 2:GROUND FLOOR #2
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8778
Mailing Address - Country:US
Mailing Address - Phone:212-726-8314
Mailing Address - Fax:
Practice Address - Street 1:36 W 11TH ST
Practice Address - Street 2:GROUND FLOOR #2
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8778
Practice Address - Country:US
Practice Address - Phone:212-726-8314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-31
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012212103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical