Provider Demographics
NPI:1801011093
Name:GOCHBERG, BARBARA DIANE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:DIANE
Last Name:GOCHBERG
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 1:4680 INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3537
Mailing Address - Country:US
Mailing Address - Phone:718-601-7805
Mailing Address - Fax:718-601-6631
Practice Address - Street 1:2600 NETHERLAND AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-4801
Practice Address - Country:US
Practice Address - Phone:718-601-7805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011958103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical