| Doctor Name: | MS. MARY L GOLDBERG |
| NPI Number: | 1114945193 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS,RN,CS |
| License Number: | 158556 |
| Business Practice Address: | 53 Langley Rd Suite 330 Newton Center, MA - 024591913 |
| Business Phone Number: | 6176711239 |
| Business Fax Number: | 6176711239 |
| Mailing Address: | 53 Langley Rd, Suite 330 NEWTON CENTER |
| State: | MA |
| Postal Code: | 024591913 |
| Phone Number: | 6176711239 |
| Fax Number: | 6176711239 |
| NPI Enumeration Date: | 07/17/2006 |
| NPI Last Update Date: | 03/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0809X |
| License Number: | 158556 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |