Goodman, Jack
Goodman, Jack is an individual health care provider with primary practice located at 9 Livingston St Ste 5, Poughkeepsie NY 12601. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Goodman, Jack can be contacted via phone (845) 454-0415.Contact Information
Primary practice address
9 Livingston St Ste 5
Poughkeepsie NY 12601
Phone: (845) 454-0415
Fax: (845) 454-0914
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 86055 | New York |
Profile Details
| NPI number | 1831292051 |
|---|---|
| LBN Legal business name | Goodman, Jack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 6th, 2006 |
| Last updated | Sep 4th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1831292051 | NPPES |
| New York | Other | 147049 | MVP |
| New York | Other | C13377 | MVP |
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