| Ayelet P Goldberg, Lcsw, Pllc | |
|
6143 186th St Ste 312 Fresh Meadows NY 11365-2710 | |
| (917) 923-7644 | |
| Not Available |
| Full Name | Ayelet P Goldberg, Lcsw, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 6143 186th St Ste 312, Fresh Meadows, New York |
| Authorized Official Name and Position | Ayelet P Goldberg (SOCIAL WORKER) |
| Authorized Official Contact | 9179237644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ayelet P Goldberg, Lcsw, Pllc 6143 186th St Ste 312 Fresh Meadows NY 11365-2710 Ph: (917) 923-7644 | Ayelet P Goldberg, Lcsw, Pllc 6143 186th St Ste 312 Fresh Meadows NY 11365-2710 Ph: (917) 923-7644 |
| NPI Number | 1003368879 |
|---|---|
| Provider Enumeration Date | 10/27/2016 |
| Last Update Date | 04/16/2018 |
| Medicare PECOS PAC ID | 8921381138 |
|---|---|
| Medicare Enrollment ID | O20170214002016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003368879 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 082421 (New York) | Primary |
| Provider Name | Ayelet Goldberg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407146285 PECOS PAC ID: 3678674470 Enrollment ID: I20150406001479 |
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