Provider Demographics
NPI:1003614140
Name:GOODHAVEN HEALTH PLLC
Entity type:Organization
Organization Name:GOODHAVEN HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:RITZ
Authorized Official - Last Name:WITT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-265-3072
Mailing Address - Street 1:160 ALEWIFE BROOK PKWY # 1193
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:625 MOUNT AUBURN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-4555
Practice Address - Country:US
Practice Address - Phone:857-678-3901
Practice Address - Fax:857-314-6445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty