Provider Demographics
NPI:1629391958
Name:GOLDBERG, NAOMI SHARON (RPH)
Entity Type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:SHARON
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 MAMARONECK AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1440
Mailing Address - Country:US
Mailing Address - Phone:914-287-7650
Mailing Address - Fax:
Practice Address - Street 1:325 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1440
Practice Address - Country:US
Practice Address - Phone:914-287-7650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047082183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist