Robin Esther Gomolin, PSYA.D
Individual provider Active NPI Psychoanalyst · Chestnut Hill, MA
NPI 1508098351 · NPPES record last updated Aug 12, 2009
Key facts
- NPI
- 1508098351
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychoanalyst 102L00000X
- License
- 000703-1 (NY)
- Practice address
- 154 Wallis Rd
Chestnut Hill, MA 02467-3113 - Phone
- (617) 325-5713
- NPI assigned
- Aug 12, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 11, 2024 through Nov 11, 2026
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000703-1 | NY | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychoanalyst | 102L00000X | 000703-1 | NY | Yes |
Addresses
Primary practice location
154 Wallis Rd
Chestnut Hill, MA 02467-3113
Mailing address
154 Wallis Rd
Chestnut Hill, MA 02467-3113
Phone (617) 325-5713
Other providers in Chestnut Hill, MA
- Reeve Goldhaber
- James A Goldman
- Robert D Goldman
- Howard George Goldsweig
- Olga E Golub
- Michael Ian Good
- Michelle Goodrich
- Harsha Vinayak Gopal
- Susan Ruth Gordon
- Rebecca Gollub Gottesman
All providers in Chestnut Hill, MA · Psychoanalyst in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.