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NPI Code Detail

MEDICARE: MADISON LEIGH GOODMAN

MEDICARE:   MADISON LEIGH GOODMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN10019968MA

General Provider Information

NPI Number : 1053277905
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISON LEIGH GOODMAN
Provider Business Mailing Address
First Line : 81 HIGHLAND AVE
Second Line :
City : SALEM
State : MA
Zip : 01970-2768
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 81 HIGHLAND AVE
Second Line :
City : SALEM
State : MA
Zip : 01970-2768
Country : US
Telephone Number : 703-424-0470
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “ MADISON LEIGH GOODMAN ” Practice Location

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