Provider Demographics
NPI:1932204757
Name:GOLDBERG, ANN (OTR, CHT)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EXPRESSWAY PLZ
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2047
Mailing Address - Country:US
Mailing Address - Phone:516-625-6600
Mailing Address - Fax:516-625-1819
Practice Address - Street 1:1 EXPRESSWAY PLZ
Practice Address - Street 2:SUITE 106
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2047
Practice Address - Country:US
Practice Address - Phone:516-625-6600
Practice Address - Fax:516-625-1819
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001270225X00000X, 225XH1200X, 332BC3200X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY001270SOtherHEALTHCARE PARTNERS
NYQRW351OtherEMPIRE MEDICARE NUMBER
NY0029110OtherAETNA (ORTHONET )
NYANC1449OtherOXFORD
NY4C0378OtherHEALTHNET
NMQS7142OtherEMPIRE
NY6636543OtherCIGNA
NY11478170OtherCAQH
NY4465856OtherAETNA
NY001270 N02OtherHIP
NY0029110OtherHEALTHNET (ORTHONET )
NY29110OtherCIGNA ( ORTHONET )