Provider Demographics
NPI:1669656278
Name:GOLDBERG, FRANCINE RUTH (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANCINE
Middle Name:RUTH
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 HWY 35 # 105-130
Mailing Address - Street 2:
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-3502
Mailing Address - Country:US
Mailing Address - Phone:917-301-7518
Mailing Address - Fax:888-858-3959
Practice Address - Street 1:1933 HWY 35 # 105-130
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07719-3502
Practice Address - Country:US
Practice Address - Phone:917-301-7518
Practice Address - Fax:888-858-3959
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37RC00103000101Y00000X
NY001403101YM0800X
NJ37PC00099500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health