Provider Demographics
NPI:1881191385
Name:GOLDSTEIN, MINDA M
Entity Type:Individual
Prefix:
First Name:MINDA
Middle Name:M
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:MONSEY
Mailing Address - State:NY
Mailing Address - Zip Code:10952-3740
Mailing Address - Country:US
Mailing Address - Phone:845-356-8400
Mailing Address - Fax:
Practice Address - Street 1:58 ROUTE 59
Practice Address - Street 2:
Practice Address - City:MONSEY
Practice Address - State:NY
Practice Address - Zip Code:10952-3740
Practice Address - Country:US
Practice Address - Phone:845-356-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator