Goodman, Steven I

Goodman, Steven I is an sole proprietor health care provider with primary practice located at 1643 Route 112 Ste A , Medford NY 11763-3654. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Goodman, Steven I can be contacted via phone (631) 758-5575.

Contact Information

Primary practice address
1643 Route 112 Ste A Medford NY 11763-3654
Phone: (631) 758-5575
Fax: (631) 758-5579
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X VUT005113 New York

Profile Details

NPI number 1316146673
LBN Legal business name Goodman, Steven I
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 16th, 2007
Last updated Nov 18th, 2009 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316146673 NPPES
New York MEDICAID 01224079

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