Provider Demographics
NPI:1801150057
Name:GOODRICH, ANITA KAUR (MD,)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:KAUR
Last Name:GOODRICH
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Gender:F
Credentials:MD,
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Mailing Address - Street 1:345 US RT 296
Mailing Address - Street 2:
Mailing Address - City:HENSONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12439-5128
Mailing Address - Country:US
Mailing Address - Phone:518-734-3260
Mailing Address - Fax:518-734-5289
Practice Address - Street 1:345 US RT 296
Practice Address - Street 2:
Practice Address - City:HENSONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12439-5128
Practice Address - Country:US
Practice Address - Phone:518-734-3260
Practice Address - Fax:518-734-5289
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2024-12-20
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Provider Licenses
StateLicense IDTaxonomies
NY291297207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine