1548605306 NPI number — MS. BIANCA VENTURA GOLDMAN LCSW

Table of content: MS. BIANCA VENTURA GOLDMAN LCSW (NPI 1548605306)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548605306 NPI number — MS. BIANCA VENTURA GOLDMAN LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VENTURA GOLDMAN
Provider First Name:
BIANCA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VENTURA
Provider Other First Name:
BIANCA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1548605306
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/02/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
58 PAMELA RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORTLANDT MANOR
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10567-7118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-737-7338
Provider Business Mailing Address Fax Number:
914-737-1050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1101 MAIN ST
Provider Second Line Business Practice Location Address:
C/O WJCS
Provider Business Practice Location Address City Name:
PEEKSKILL
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10566-2907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-737-7338
Provider Business Practice Location Address Fax Number:
914-737-1050
Provider Enumeration Date:
05/07/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  080075 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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