Provider Demographics
NPI:1982720744
Name:GOLDMAN, AMY F
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:F
Last Name:GOLDMAN
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 1:207 E 74TH ST
Mailing Address - Street 2:6L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3339
Mailing Address - Country:US
Mailing Address - Phone:212-772-3939
Mailing Address - Fax:212-772-2277
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:BAKER F-18
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4870
Practice Address - Country:US
Practice Address - Phone:212-746-6700
Practice Address - Fax:212-746-8159
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006195225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist