Provider Demographics
NPI:1629209770
Name:GOLDMAN, RINA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RINA
Middle Name:
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2072 OCEAN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230
Mailing Address - Country:US
Mailing Address - Phone:718-616-1450
Mailing Address - Fax:718-743-8186
Practice Address - Street 1:2072 OCEAN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-7379
Practice Address - Country:US
Practice Address - Phone:718-616-1450
Practice Address - Fax:718-743-8186
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015801235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist