Provider Demographics
NPI:1336307537
Name:GOODMAN, MARGARET (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:185 GENESEE ST STE 600
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-2199
Mailing Address - Country:US
Mailing Address - Phone:520-404-7212
Mailing Address - Fax:
Practice Address - Street 1:185 GENESEE ST STE 600
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-2199
Practice Address - Country:US
Practice Address - Phone:315-793-8806
Practice Address - Fax:215-793-8046
Is Sole Proprietor?:No
Enumeration Date:2008-05-26
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ356902085R0202X, 2085R0202X
NY2730702085R0202X
CA1094582085R0202X
PAMD4505472085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology