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Contact Information

CLARK R GOLDSTEIN, PhD
1981 MARCUS AVENUE
SUITE C-102 NYU CHILD STUDY CENTER
LAKE SUCCESS, NY11042
 Phone: 516-358-1808
 Fax: 646-754-9854
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for CLARK R GOLDSTEIN · (Male)

NPI Number 1215121710
Status Active
Credentials PhD
Entity Individual
Enumeration date 08/29/2007
Last updated 04/07/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 019503
  • NY License # 50019503
  • MA Medicaid 1312677
  • MA Other M18708 BLUE CROSS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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