Goldberg, Mary L

Goldberg, Mary L is an sole proprietor health care provider with primary practice located at 53 Langley Rd Suite 330, Newton Center MA 02459-1913. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult, which is considered as her primary health care specialty. Goldberg, Mary L can be contacted via phone (617) 671-1239.

Contact Information

Primary practice address
53 Langley Rd Suite 330 Newton Center MA 02459-1913
Fax: (617) 671-1239
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult 364SP0809X 158556 Massachusetts

Profile Details

NPI number 1114945193
LBN Legal business name Goldberg, Mary L
Credentials MS,RN,CS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 17th, 2006
Last updated Mar 28th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114945193 NPPES
Massachusetts Other 458483 TUFTS
Massachusetts Other PN0833 TUFTS

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