Provider Demographics
NPI:1609065960
Name:GOLDMAN, HARRIET DUCKLER (SLP)
Entity Type:Individual
Prefix:MS
First Name:HARRIET
Middle Name:DUCKLER
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 STRATFORD N
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2316
Mailing Address - Country:US
Mailing Address - Phone:516-484-2008
Mailing Address - Fax:
Practice Address - Street 1:100 STRATFORD N
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2316
Practice Address - Country:US
Practice Address - Phone:516-484-2008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005071235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist