Tyra Amirah Goldstein

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

201 King of Prussia Rd Ste 650
Radnor, PA 19087-5156

Phone

(215) 853-6682

Fax

(855) 568-2494

NPI assigned

Oct 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1666051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1831815091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 KING OF PRUSSIA RD STE 650",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190875156",
            "telephone_number": "215-853-6682",
            "fax_number": "855-568-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 KING OF PRUSSIA RD STE 650",
            "city": "RADNOR",
            "state": "PA",
            "postal_code": "190875156",
            "telephone_number": "215-853-6682",
            "fax_number": "855-568-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "TYRA",
        "middle_name": "AMIRAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-18",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol R Fleischman, MD
• Brian Douglas Fletcher, PAC
• Aileen Patricia Gavin, CRNP
• Christine A Gearhart, CRNP
• Danielle Gill, LSW
• Good Steward Home Care LLC
• Jeffrey M Gramp, MD
• Denna M Grande
• Brian Griffin, RN
• Roslyn Grossinger

• All providers in Radnor, PA
• Behavior Technician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.