Goodwin, Diane

Goodwin, Diane is an sole proprietor health care provider with primary practice located at 30 Shelburne Rd , Stamford CT 06902-3628. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Goodwin, Diane can be contacted via phone (203) 276-1000.

Contact Information

Primary practice address
30 Shelburne Rd Stamford CT 06902-3628
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 000205 Connecticut

Profile Details

NPI number 1053467605
LBN Legal business name Goodwin, Diane
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 26th, 2007
Last updated Jan 8th, 2016 - about 9 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 1053467605 NPPES
Connecticut Other 000205 CT LICENSE

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