Provider Demographics
NPI:1447026760
Name:GOLDBERG, MARGARET ANN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:GOLDBERG
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-2221
Mailing Address - Country:US
Mailing Address - Phone:201-248-0543
Mailing Address - Fax:201-701-0320
Practice Address - Street 1:659 ORCHARD LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-2221
Practice Address - Country:US
Practice Address - Phone:201-248-0543
Practice Address - Fax:201-701-0320
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00391200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist