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NPI Code Detail

MEDICARE: BRUCE GOODHEART P.T.

MEDICARE: BRUCE GOODHEART P.T.
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
1225100000XPhysical Therapist013032

General Provider Information

NPI Number : 1588845390
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE GOODHEART P.T.
Provider Business Mailing Address
First Line : 11 FRANKLIN PL
Second Line :
City : WOODMERE
State : NY
Zip : 11598-1216
Country : US
Telephone Number : 516-569-0373
Fax Number : 516-569-0374
Provider Business Practice Location Address
First Line : 11 FRANKLIN PL
Second Line :
City : WOODMERE
State : NY
Zip : 11598-1216
Country : US
Telephone Number : 516-569-0373
Fax Number : 516-569-0374
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2007
Last Update Date : 11/13/2019

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