Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 5616 | NY |
Y | 103TC0700X | Clinical Psychologist | 5616 | NY |
NPI | 1003198557 |
---|---|
Provider Name | Dr. Elizabeth R Goren |
First Address | New York, NY 10003-6724 |
Second Address | New York, NY 10003-6724 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2011 |
Last Update Date | 11/09/2011 |