Provider Demographics
NPI:1174857007
Name:GOODMAN-KLEIN, BETTY
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:GOODMAN-KLEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8232 VAN BUREN DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-4464
Mailing Address - Country:US
Mailing Address - Phone:412-496-9104
Mailing Address - Fax:
Practice Address - Street 1:8232 VAN BUREN DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-4464
Practice Address - Country:US
Practice Address - Phone:412-496-4163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP000203A363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care