Provider Demographics
NPI:1477530285
Name:GOODMAN, STEVEN L (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
Last Name:GOODMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6655 FRESH POND RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-3261
Mailing Address - Country:US
Mailing Address - Phone:718-497-1919
Mailing Address - Fax:718-386-2152
Practice Address - Street 1:6655 FRESH POND RD
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385
Practice Address - Country:US
Practice Address - Phone:718-497-1919
Practice Address - Fax:718-386-2152
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2018-06-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY143929207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C09461Medicare UPIN