Phyllis H. Goltra, P.C.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS006504L Issued in PA

Legal business name

PHYLLIS H. GOLTRA, P.C.

Practice address

1616 Walnut St
Suite 1616
Philadelphia, PA 19103-5313

Phone

(215) 545-8441

Fax

(215) 985-1129

NPI assigned

Apr 19, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Phyllis H. Goltra, PH.D.

Title

President

Phone

(215) 545-8441

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Helen Huffington, M.S.S.

  • Clinical Social Worker
  • Philadelphia, PA
  • NPI 1033202965
  NPD (past)
• Elliott B Rotman, PH.D.

  • Clinical Psychologist
  • Wyncote, PA
  • NPI 1790842342
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243814400000",
    "number": "1164487500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 WALNUT ST",
            "address_2": "SUITE 1616",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191035313",
            "telephone_number": "215-545-8441",
            "fax_number": "215-985-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 WALNUT ST",
            "address_2": "SUITE 1616",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191035313",
            "telephone_number": "215-545-8441",
            "fax_number": "215-985-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYLLIS H. GOLTRA, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2009-06-01",
        "status": "A",
        "authorized_official_last_name": "GOLTRA",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-545-8441",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS006504L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7244008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Phung
• Khanh Phung
• Quang Phung, CRNP
• Phuong H DO
• Sophavy Phuong
• Sai Aung Phyo, MD, PHD
• Physical Corrective Solutions, LLC
• Physical Medicines & Acupuncture LTD
• Physician Management Services of Eastern Pennsylvania II, LLC
• Physician Oncology, LTD.

• Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.