Provider Demographics
NPI:1750676144
Name:GOLDSTEIN, YOCHEVED A (MA)
Entity Type:Individual
Prefix:
First Name:YOCHEVED
Middle Name:A
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 E 8TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1902
Mailing Address - Country:US
Mailing Address - Phone:732-367-7293
Mailing Address - Fax:
Practice Address - Street 1:182 MARION CT
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4647
Practice Address - Country:US
Practice Address - Phone:732-363-3297
Practice Address - Fax:732-612-1265
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00614100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist