Provider Demographics
NPI:1568724276
Name:GOODMAN, BARBARA (MS)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 BARRETT CIR
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4263
Mailing Address - Country:US
Mailing Address - Phone:631-423-5343
Mailing Address - Fax:
Practice Address - Street 1:128 BARRETT CIR
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-4263
Practice Address - Country:US
Practice Address - Phone:631-423-5343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist