Provider Demographics
NPI:1679325476
Name:GOODMAN, NAJAH R (NP)
Entity Type:Individual
Prefix:
First Name:NAJAH
Middle Name:R
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07063-1213
Mailing Address - Country:US
Mailing Address - Phone:908-644-7918
Mailing Address - Fax:
Practice Address - Street 1:1180 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2810
Practice Address - Country:US
Practice Address - Phone:908-654-0020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14948100363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology