Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003405564 |
---|---|
Provider Name | Chaim B Goldberg |
First Address | Monsey, NY 10952-3646 |
Second Address | Monsey, NY 10952-3646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2021 |
Last Update Date | 11/01/2021 |