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NPI Code Detail

MEDICARE: DR. LAURA MANFIELD-GOODRIDGE DO

MEDICARE: DR. LAURA MANFIELD-GOODRIDGE DO
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
1208100000XPhysical Medicine & Rehabilitation Physician257453MA

General Provider Information

NPI Number : 1295994010
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAURA MANFIELD-GOODRIDGE DO
Provider Business Mailing Address
First Line : 280 CHESTNUT ST
Second Line : 2ND FLOOR
City : SPRINGFIELD
State : MA
Zip : 01199-1001
Country : US
Telephone Number : 413-794-5700
Fax Number :
Provider Business Practice Location Address
First Line : 17 RESEARCH DR
Second Line :
City : AMHERST
State : MA
Zip : 01002-2788
Country : US
Telephone Number : 413-549-8400
Fax Number : 413-549-8409
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2008
Last Update Date : 08/22/2019

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