Provider Demographics
NPI:1619056314
Name:GOOD HEALTH MEDICAL, P.C.
Entity Type:Organization
Organization Name:GOOD HEALTH MEDICAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:BEKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-743-9700
Mailing Address - Street 1:3019 BRIGHTON 1ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-8008
Mailing Address - Country:US
Mailing Address - Phone:718-743-9700
Mailing Address - Fax:718-332-3511
Practice Address - Street 1:3019 BRIGHTON 1ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8008
Practice Address - Country:US
Practice Address - Phone:718-743-9700
Practice Address - Fax:718-332-3511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214482207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02383842Medicaid
NY02383842Medicaid
NY4443660001Medicare NSC