Provider Demographics
NPI:1881693398
Name:ARTHRITIS AND OSTEOPOROSIS MEDICAL ASSOCIATES
Entity type:Organization
Organization Name:ARTHRITIS AND OSTEOPOROSIS MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:GODDARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-858-3263
Mailing Address - Street 1:186 JORALEMON ST
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4326
Mailing Address - Country:US
Mailing Address - Phone:718-858-3263
Mailing Address - Fax:718-858-5095
Practice Address - Street 1:186 JORALEMON ST
Practice Address - Street 2:8TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4326
Practice Address - Country:US
Practice Address - Phone:718-858-3263
Practice Address - Fax:718-858-5095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEM271Medicare ID - Type Unspecified