| Doctor Name: | GARY MARSHALL GOLDSTEIN |
| NPI Number: | 1114033263 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | 102691 |
| Business Practice Address: | 565 Turnpike Street Suite 81 North Andover, MA - 01845 |
| Business Phone Number: | 9186821579 |
| Business Fax Number: | 9786894582 |
| Mailing Address: | 565 Turnpike Street, Suite 81 NORTH ANDOVER |
| State: | MA |
| Postal Code: | 01845 |
| Phone Number: | 9186821579 |
| Fax Number: | 9786894582 |
| NPI Enumeration Date: | 08/22/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 102691 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |