Provider Demographics
NPI:1689054207
Name:GOODMAN, SOMMER (MS)
Entity Type:Individual
Prefix:
First Name:SOMMER
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 1:1655 FLATBUSH AVE
Mailing Address - Street 2:APT B403
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3276
Mailing Address - Country:US
Mailing Address - Phone:832-689-9749
Mailing Address - Fax:
Practice Address - Street 1:1655 FLATBUSH AVE
Practice Address - Street 2:APT B403
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3276
Practice Address - Country:US
Practice Address - Phone:832-689-9749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist