Provider Demographics
NPI:1790118768
Name:GOLDFARB, TESS MORGAN (MA)
Entity Type:Individual
Prefix:
First Name:TESS
Middle Name:MORGAN
Last Name:GOLDFARB
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 1:3 FORREST DR
Mailing Address - Street 2:
Mailing Address - City:LLOYD HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11743-9740
Mailing Address - Country:US
Mailing Address - Phone:516-297-4234
Mailing Address - Fax:
Practice Address - Street 1:3 FORREST DR
Practice Address - Street 2:
Practice Address - City:LLOYD HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11743-9740
Practice Address - Country:US
Practice Address - Phone:516-297-4234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist