Provider Demographics
NPI:1851924070
Name:GOGGINS, DEBRA IRENE (CHHA, RBT)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:IRENE
Last Name:GOGGINS
Suffix:
Gender:F
Credentials:CHHA, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CAMP LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-1002
Mailing Address - Country:US
Mailing Address - Phone:973-997-9597
Mailing Address - Fax:
Practice Address - Street 1:98 MAIN ST
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-1409
Practice Address - Country:US
Practice Address - Phone:973-997-9597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-17
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NH17127300374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty