Provider Demographics
NPI:1023366846
Name:GOECKERITZ, SCOTT JONATHAN (PA)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:JONATHAN
Last Name:GOECKERITZ
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Gender:M
Credentials:PA
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Mailing Address - Street 1:506 SIXTH STREET, NEW YORK METHODIST HOSPITAL
Mailing Address - Street 2:DEPT. OF NEUROSURGERY
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215
Mailing Address - Country:US
Mailing Address - Phone:718-780-5942
Mailing Address - Fax:718-780-3287
Practice Address - Street 1:506 SIXTH STREET NEW YORK METHODIST HOSPITAL
Practice Address - Street 2:DEPARTMENT OF NEUROSURGERY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215
Practice Address - Country:US
Practice Address - Phone:718-780-5942
Practice Address - Fax:718-780-3287
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2023-05-12
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Provider Licenses
StateLicense IDTaxonomies
NY1106464363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant